Primary care trusts that are not implementing practice-based commissioning can expect to receive a letter from GPs asking them to take action.

The British Medical Association last week issued its members with a sample letter to send to reluctant PCTs, reminding them of GPs' entitlements under the Department of Health's guidance.

It sets out what PCTs should be doing on governance, management, local incentives, plurality, procurement and information. The letter reminds PCTs that all aspects of their budget should be devolved to practices, which will hand back elements based upon their PBC plan.

'This will include funding for the PCTs' central management team,' it says. 'PCTs are to set out what practices can expect in return for this funding.'

If the PCT does not deliver on its commitment, there is provision for practices to negotiate a budget from the PCT to procure these services independently, says the letter.

BMA GPs committee deputy chair Dr Laurence Buckman said the letter had been written because around one in 10 PCTs was doing nothing to develop PBC. The GPC's concerns were shared by the DoH, he added.