Primary Care Groups

In 1997, the government stated in its white paper The new NHS: modern, dependable, that it would abolish GP fundholding (a model which was established in 1990, enabling GPs to purchase local services) and establish primary care groups (PCGs), which would become a centrepiece of its reforms.

The knock-on effect on the rest of the NHS structure was only slowly appreciated. Money was increasingly disbursed through PCGs and primary care trusts (PCTs).

On 1 April 1999, family health authorities (previously responsible for commissioning primary care) were abolished and 481 PCGs were established in England. In parallel, the functions of the district authorities became minimal as PCGs (and later PCTs) took over hospital commissioning.

For the first time since the NHS's inception in 1948, PCGs were responsible for commissioning both primary and community health services and, increasingly, hospital services.

PCGs had an average population coverage of 100,000, and were effectively subcommittees of health authorities. They were required to:

• commission health services for their population
• promote the health of the population, working in partnership with other agencies
• contribute to the health authority's health improvement programme on health and healthcare
• monitor performance against service agreements with NHS trusts
• develop primary care through joint working across practices.

The aspiration was that eventually PCGs would become freestanding and develop into PCTs. Indeed, the 2000 NHS Plan announced that PCGs would develop into PCTs by April 2004.

Later, the Shifting the balance white paper brought forward the date by which all PCGs were to become PCTs to April 2002.