ABSTRACT
The concept of fundholding is the latest, and perhaps the most far reaching, change in the delivery of patient care since the NHS was conceived. There are many arguments for and against fundholding, both political and ethical, however this chapter will ignore these debates and deal with the current parameters of the scheme. This chapter gives the plans for the future of the NHS and the main initiative was the introduction of general practice fundholding. It outlines some pilot studies that bring other responsibilities under the jurisdiction of the general practitioner (GP) fundholder. Fundholding has tremendous implications on all areas of the practice and it should not be judged in isolation. Fundholding simply demands greater detail and includes the number of follow-ups in out-patient clinics, type and number of in-patient episodes and day cases. The management allowance exists for practices to use to offset certain expenses that have been necessary as a direct result of fundholding.
