GPs in an area planning to give practices real commissioning budgets have warned that the budgets could be imposed on them by cash-strapped PCTs.
GPs in north Essex are lobbying for all-profession support to ban PCTs imposing cash budgets and forcing unwilling practices into commissioning clusters.
North Essex is part of the East of England SHA, which plans to pilot hard budgets next year, regardless of which party is in power.
Essex LMCs chief executive Dr Brian Balmer said: 'East of England don't do consent. They are totally top down. Forcing cash budgets through would be disastrous.'
East of England SHA is facing a cash shortfall of around £2 billion over the next three years.
A board discussion paper presented at the last SHA meeting says: 'One way of controlling demand - and therefore supporting strategic work around improving quality at the same time as reducing the funding gap - is through moving practice-based commissioning (PBC) to hard budgets.'
Dr Balmer added: 'Post-election the funding will shrink. You hand the budget to someone when it's going to drop.'
He warned GPs must only agree to hard budgets under arrangements that are 'very tight legally and financially'.
'We'll be in a different world post-election. The temptation will be to force things through.'
North Essex LMC has submitted a motion to the UK LMCs conference asking that no practice be 'forced to hold an actual, rather than indicative, commissioning budget'.
A second motion calls for commissioning clusters to only include practices 'following the voluntary decision of the practice'.
East of England SHA leads the country in support for PBC, with hard budget pilots running in NHS Cambridgeshire, NHS South East Essex and NHS North East Essex, and 'strong interest' in NHS Bedfordshire.
NHS East of England said: 'Any decisions to take forward hard budgets will be taken locally as a partnership between clinicians and commissioners.'