According to a recent Freedom of Information (FoI) request, a number of Clinical Commissioning Groups (CCGs) are ploughing millions of pounds into general practice in a move that equates to £195m of new local contracts for practices.

In addition, the request found that total spending on locally commissioned enhanced services, or direct contracts, has increased year-on-year from £59m in 2013/14 to £103.5m this year.

Meanwhile, in further good news for GPs, CCGs are bypassing competition for enhanced services, with only 8 per cent of contracts being commissioned through procurement. Instead, they are developing packages with a single pot of money for practices to provide a range of services.

However, not all CCGs have cash to give away; in fact, 39 of them finished the last financial year in deficit. In addition, instead of offering cash, some of them are rationing front-line services, such as treatment for smokers and obese patients, hearing aids, vasectomies and IVF treatment. Meanwhile, others are encouraging GPs to stop prescribing over-the counter medicines as a cost-cutting exercise.

There is also a real danger that CCGs might be merged with other bodies or even abolished in a bid to save money, which could mean that the progress made so far has been wasted.

According to GP magazine Pulse, secret sustainability and transformation plans (STPs) have been drawn up by NHS England and are currently being considered.

These involve health and care services being planned by geographical area, rather than around individual organisations, and are thought to contain some radical cost-saving measures to ensure the health service comes back to financial balance.

The FoI request also revealed a slight fall in public health contracts with GP practices in 2016/17 to £102.1m across England, compared with £104.3m last year and £112.5m in 2014/15.