Practice based commissioning is dead. Primary care tsar David Colin-Thomé, unable to find signs of life, has written its death certificate.

Six months ago, in a desperate attempt to resuscitate the initiative, the Department of Health issued new guidance to get practice based commissioning working to its “full potential”. In this case full potential is virtually no potential at all.

The collapse of this policy calls into question the wisdom of the Conservatives placing GP commissioning at the centre of their health manifesto. The proposal to give GPs “hard budgets” - getting their hands on the cash - may cause the odd twitch of life, but it is difficult to see the idea taking off to the extent that there is a substantial shift in commissioning power away from primary care trusts unless there is a large profit in it.

Effective commissioning is essential for driving quality and efficiency in hospitals, and has a pivotal role to play in delivering the £20bn of savings.

There is a danger the next government will strip PCTs of the capacity they have built up under world class commissioning without providing a viable alternative.

GP commissioning is turning in its grave