Primary care has long been the underdog of the NHS, handling routine care while hospital trusts manage high-profile services.

But times are changing. The government sees primary care as more efficient than secondary care and as a gateway to specialist services, so is keen to build on its role.

Primary care trusts in England now control over 80 per cent of the NHS budget and have the power to shape services in their locality, partly by giving GPs commissioning budgets. Meanwhile, PCTs have been charged with improving their own skills and becoming world class commissioners.

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