The Department of Health has published a list of the primary care trusts which will be most disadvantaged as a result of changes to the way GP pay is allocated.

Figures reveal 76 PCTs will find themselves under financial pressure as a result of the change.

Nine PCTs will need to top up GP pay by more than 2 per cent of this year’s allocation increase. Ashton, Leigh and Wigan PCT is the worst hit.

A further 21 PCTs face shortfalls of 1-2 per cent of the increase because of the changes.

These include the gradual phasing out of the minimum practice income guarantee and adjusting the GP quality and outcomes framework scheme.

But four PCTs will be more than 2 per cent better off and 21 will be 1-2 per cent better off in proportion to their allocation uplifts.

Anthony Gardner, chief executive of Cumbria PCT, one of the nine worst hit, said his organisation was benchmarking the DH data against its own internal assessments to find out “the implications and how we are going to handle them”.

He said: “We’ve got quite a good arrangement for the involvement of GPs so we’ll work out what the implications are, work up a set of options and take them to them.”

Mr Gardner said Cumbria had been badly hit because many of its GPs work in small practices being sustained by the minimum practice income guarantee.

The changes have been designed to fund core GP services more equitably.

Framework payments will be changed to reflect recorded prevalence of long term conditions.

Earlier this year, the British Medical Association warned that “dozens” of practices could close unless help was provided to ease the transition away from the old way of funding the framework.

HSJ is holding a conference on practice based commissioning in London on 1 July,

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