Just £5.3bn of around £7.6bn in funding allocated to primary care services in 2015/16 was directly delivered by the national commissioning body, NHS England's accounts show.
The previous year NHS England allocated £7.3bn directly to primary care services.
Around a third of the funding in 2015/16 was handed to CCGs with delegated co-commissioning powers. CCGs also control other GP funding streams through commissioning local services.
Primary care commissioning
More than half of England's 209 CCGs currently have fully delegated primary care arrangements, with powers to commission services. NHS England has said it expects all CCGs will have fully delegated powers by 2017/18.
The new figures, published in NHS England’s annual accounts on Thursday, came as 26 CCGs were declared ‘inadequate’ under the new ratings system, with a further 91 marked as ‘requires improvement’. Nine inadequate CCGs have been placed into a special measures regime which could see failing groups disbanded, merged, replaced with accountable care organisations (ACOs) or have new leaders imposed.
CCGs were rated according to five domains: well-led organisation, delegated functions - including primary care commissioning where relevant - finance, performance and planning.
GPC deputy chairman Dr Richard Vautrey warned that pratices were becoming more and more dependent on local funding streams 'which in turn is dependent on managing local deficits'.
Significant tranches of additional GP funding could come from sustainability and transformation plans currently being drawn up in each of 44 'footprint' areas across England, and NHS England's GP Forward View made clear that funding allocated by local commissioners would supplement increased investment in general practice.
Dr Vautrey said: 'This postcode lottery is not good for the sustainability of general practice nor the consistent delivery of services to patients.'
New powers for NHS England to replace struggling CCGs with ACOs could exacerbate the risk unless 'the wider funding deficits are addressed through increased NHS investment', he added.