A major study into practice based commissioning has found it to be an 'expensive investment' that has delivered little in terms of better services for patients or financial savings.
The King's Fund is urging the Department of Health to use the "reinvigoration" of practice based commissioning announced in the next stage review to set out a "clear vision" for the initiative.
Primary care trusts should retain responsibility for strategic commissioning but with clinician involvement. High performing practice based commissioners should be rewarded with increased independence but should not become responsible for the entire healthcare budget.
Report author and senior fellow Nick Goodwin said it was essential that the government told people "exactly what the roles and responsibilities of individual parties are".
The report said even though GPs had received nearly£100m in incentive payments, few were commissioning new services, instead focusing on changing service provision.
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