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Journal round up

Over the next few months, general practitioners in England will be taking more responsibility for commissioning health services for their patients, probably within newly created Clinical Commissioning Groups. This study of the way managers in the existing Primary Care Trusts have behaved, contains lessons for GPs as commissioners. They will need a deep understanding of the ways the whole healthcare system works. They will need to ensure that the multiple organizational layers and lack of clarity as to how decisions get made do not obstruct their goals. One successful type of commissioning manager identified in this study is designated the ‘animateur’ – someone who successfully manages disparate groups over whom they don’t actually have any formal authority. This is almost certainly going to be a feature of the situation that GPs find themselves, in the brave new world that awaits them.