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All goes back to 3 things:

- A lack of independent assurance about the disagregation of PCT budgets, with many howlers made (You will witness a counterproductive disinvestment in primary care to 'recreate' the 3.5% cushion Bauman speaks about because it did not move from PCTs in proportion to primary care contracts budgets.)

- A lack of formal version control between the information rules, and specialised definitions, and that original budget splitting to keep the money in line with the funding obligations.

- A lack of clarity about transferring pre-commitments and funding obligations (major developments and primary care premises being 2 clear examples)

As a result there are CCGs struggling and there are Area Teams with unachievable cost savings requirements.

Sadly it wont be self financing as those parts of the system who are currently quiet, who have an overallocation - and may not recognise it - will plan and spend their money in line with their statutory mandate. So the 'unders' will evaporate and the 'overs' will be insoluble. Trouble ahead.