A related issue is the loss of grip from the centre in relation to contracts. In many parts of the country soon to be shut commissioning organisations are agreeing deals that are contra the PbR code of conduct, which means the incentives to keep waits short designed into the payment system are no longer effective.
With experience of two GP practices, GP waiting times seem to have gone up also. It takes several days now to get an appointment when it used to be easy to get one on the same day. Also, it took 4 visits just to get a one-page print out of my son's vaccinations from a medical record -- admin staff seemed to be overworked and only part time. Is GP time being diverted to work on commissioning matters and was the cost of this factored into the so-called savings from removing NHS bureaucracy in PCTs and SHAs? Another issue is where are these savings being reinvested in the NHS -- a government promise. The CCGs don't seem to have enough money to organise themselves properly.