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Commissioning
In July 2010 a White Paper was announced by the Government, seeking to transfer NHS budgets to groups of GP
practices (GP consortia), in order to put clinicians into the driving seat of health care
commissioning
Effectively the plan is that GPs will come together in local groups and decide which clinical services to buy, where they will be purchased from, any criteria that patients must meet if they are to receive treatment, and any actions that the GP must take before they can refer the patient for treatment
An example would be that a commissioning group might decide to spend £200,000 of its budget on hip replacements. They decide that their local NHS hospital can provide this service better than a private hospital which is cheaper, but has higher post-operative infection rates, and that before patients can be referred for surgery they must have been assessed by a physiotherapist, had a bone density scan, and must have been receiving prescribed pain relief for more than 6 months
As you can see there will be a lot of work involved for GPs when creating these groups and deciding how to buy services, but one advantage is that a lot of these systems are in place already, having been managed by PCTs (Primary Care Trusts), who have performed this function since 2000, being preceded by PCGs (Primary Care Groups), and before that by HAs (Health Authorities)
In the 1990s many GPs held their own budgets for purchasing care, in a scheme known as Fundholding, and indeed Leeds Student Medical Practice were fundholders in the 1990s
If you would like more information about commissioning, please read the attached H3+ information brochure 
. H3+ is a commissioning group that we have joined, which comprises around half the GPs in Leeds
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