Primary care groups: Trade-offs in managing budgets and risk

The NHS reforms introduced on 1 April 1999 were intended to remove competit ion and promote co-ope ration. in the delivery of health care. This was to be achieved in part by the develop ment of joint working by groups of Gener al Practitioner (GP) practices covering populations of around 100,000-known as Primary Care Groups (PCGs). A Key element is the integration of respons ibility for managing both the clinical and financial aspects of delivering health care. The authors report on. the success of this new joint role, bas ed on findings from a national survey. There are trade-offs in choosing the scale at which to encourage GPs to take on their new roles. Smaller groups will be better able to integrate practices' clinical and financial respons ibilities, while larger groups will have less financial risk due to random variation.