As many as half of enhanced services could face cuts as NHS reforms take shape, a PCT adviser has warned. And the cuts could see pharmacies losing as much as £25,000 worth of annual income, others warned. Industry leaders agreed services would be at risk as trusts looked to save costs, with Hemant Patel, North-East London LPC secretary,saying: "It will come down to how much it's costing them and the will of somebody [at the PCT]." "We must remember PCTs are not democratic organisations and they will try to get away with as much as they can," he added. The comments followed the news that Doncaster PCT had cut its pharmacy quality and outcomes framework (QOF) last week. Doncaster LPC secretary Nick Hunter remained sceptical over pharmacy's power to influence commissioning, saying that decisions would come down to "cold, hard cash". Mr Hunter told C+D: "PCTs are decommissioning services up and down the country without consideration – they just don't have the money."