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They fear the new larger PCTs which took over this month will see amalgamations of former trusts as a chance to cut local enhanced services (LESs) or  pay.  

PCTs that merged as their number was halved from 303 to 152 this month were often paying different fees for the same services, or required different levels of work under similar deals.  

Many also commissioned unique LESs not available in neighbouring PCTs.  

In Sheffield, where four PCTs were amalgamated, the new organisation is understood to be considering plans to ‘centralise’ all enhanced services.  

GPC member and Sheffield GP Dr Trefor Roscoe said: ‘Now we have one PCT there are anomalies in the levels of service and payment for some services.’  

GPC negotiator and Leeds LMC chairman Dr Richard Vautrey said all areas where reorganisation had occurred were at risk of cuts.  

‘In Leeds there are different enhanced services arrangements between the old PCT areas,’ he said. ‘It is inevitable there will be some coalescing of that.’  

He said that it would be harder to retain services in areas such as Sheffield where DoH turnaround teams were tackling deficits.