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The evaluation of TPPs has three main implications for the government's proposed model of devolved purchasing; it will take considerable time for PCGs to construct robust organisations capable of bringing about important changes in local health services; effective GP-led purchasing organisations cannot be developed and maintained without substantial expenditure; and having a budget and developing independent contracts or service agreements is associated with more effective purchasing, at least in the short term."]}],"service":[{"@context":"http://iiif.io/api/search/0/context.json","profile":"http://iiif.io/api/search/0/search","label":"Search within this 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