The detailed, costed 2011-12 business plans produced by commissioners this month make interesting reading – but who will be accountable for achieving them?

NHS Bassetlaw is enticing GPs with hard cash. It has identified £5.7m of “disinvestment opportunities”, but estimates its efficiency programmes will require one-off costs of £3.7m, including money aimed at an “incentive scheme” to encourage GPs to support the schemes.

This is in contrast to NHS Nottinghamshire County, which already expects consortium leaders and practices to manage the delivery of QIPP projects this year.

However, the primary care trust is also locked in negotiations with Sherwood Forest Hospitals Trust over this year’s contract as a whole and has had to bring in “an independent third party” after “the opening positions of the trust and the PCT were felt to be too far apart for a conventional approach”.

Derbyshire County is also hopeful consortia will take it on themselves to look for savings. Its strategic plan says GPs have “a clear appetite to be involved” in financial management. But the scale of the task has at least been partly diminished by the £17m reduction in required savings, compared with initial planning, thanks to released reserves.

NHS Lincolnshire is prioritising urgent care in its QIPP plans and hopes to save £43.2m by 2015 by making systems “work effectively”. NHS Birmingham East and North must save £15.2m next year.

Despite recent publicity over reducing treatments of low clinical priority, these make up just £526,000 of savings – much smaller than the £921,000 from “mental health service redesign” or £808,000 for “medicine use and procurement”.

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