Published: 16/12/2004, Volume II4, No. 5936 Page 6

The government 'expects' all general practices to 'be involved' in practice-based commissioning by 2008, according to a Department of Health statement issued ahead of new guidance this week.

Although the guidance publication was delayed, a statement released on Tuesday revealed that the DoH has now decided to be more specific about its ultimate aim for the policy - where it had previously gone to great lengths to stress a voluntary approach. The statement read: 'Involvement in the scheme is voluntary, although the [DoH] expects all practices to be involved in practice-based commissioning by 2008.' In a separate major shift, the DoH says the new guidance will remove restrictions on the proportion of savings practices make through direct commissioning that they can retain.

The original guidance, issued in October, said practices could only keep up to 50 per cent of savings.

Now it is up to individual primary care trusts and practices to negotiate local terms. The statement says GPs 'must re-invest savings in developing or providing services for patients'. The guidance is expected to clarify whether, by whom and how this might be monitored.