Paper which draws on evidence from the US as well as on previous experience in the NHS of GP commissioning in different forms, to identify lessons for policy makers as they take this policy forward.
While the government is on the right lines in promoting GP budget holding, the paper suggests that there is a need for caution in promoting budget holding as a universal solution without regard to the capabilities of practices to manage a budget and the safeguards that need to be put in place to avoid the downside risks.