Shortfall on out-of-hours services

Most primary care trusts could find themselves '£200,000 to£300,000' short of funding for out of hours services under the new general medical services contract, it is claimed.

The estimate was given at a Commons health select committee inquiry into out of hours care, which began last week, by the chief executive of the National Association of GP Co-operatives.

Dr Mark Reynolds told MPs that PCTs would find themselves 'cash strapped' as they take on responsibility for out of hours services.

His comments came after the NHS Confederation's written evidence said resources would be unlikely 'to cover the cost of reconfiguring the entire system' despite them being 'substantial'.

Dr Ruth Livingstone, speaking for the NHS Alliance, said that its survey of 50 chairs of professional executive committees made predictions ranging 'from break even to a£400,000 shortfall' she said.

As discussions continued on how best to provide services out of hours as responsibilities shift, several parties agreed that unified budgets and emergency services might ease the burden of change.

The NHS Confederation evidence said: 'One means of nurturing sophistication within the system is by bringing all unscheduled care budgets [GP out of hours, GP in-hours, accident and emergency care, walk in centres, minor injury units, community hospitals etc] into one global fund. This could be managed by a senior, PCTbased steering group.'

British Association for Emergency Medicine president Dr Martin Shalley told HSJ: 'PCTs have got the money so It is just a question of saying 'if We have got the money we'll divide the money into emergency services and elective services'. That would be a huge job but might help.'