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Legal disputes soar as PCTs squeeze PMS practices

By Gareth Iacobucci

A massive rise in the number of recorded disputes between PMS practices and PCTs is just the ‘tip of the iceberg', the GPC said this week.

Statistics from the NHS Litigation Authority (NHSLA) show the number of disputes between PMS practices and PCTs rocketed almost six-fold between the financial years 2005/6 and 2006/7.

The rise – from 12 disputes up to 68 – is another indication of the cash squeeze facing PMS surgeries. Pulse revealed last month that GP profits, especially in PMS surgeries, were set to plummet as PCTs attempted to claw back their deficits by renegotiating contracts.

Chief executive David Nicholson revealed last week that the NHS was heading for a near £1bn profit, but the GPC warned that with 22 PCTs still in deficit and others embarking on massive cost-cutting missions, PMS surgeries remain in the firing line.

Dr Chaand Nagpaul, GPC negotiator and a GP in Stanmore, Middlesex, said many more practices were involved in payment disputes that hadn't gone as far as the NHSLA.

He said: ‘I am sure the figure conceals a larger number of cases where there is a process of disagreement at a PMS level. The problem is widespread.'

Dr Nagpaul said PCTs were attempting to alter contracts, and threatening to terminate them unless PMS practices complied. He urged the Government to intervene to ensure that PCTs ‘do not abuse the power of the local contract'.

The situation has reached crisis point in Suffolk, where the PCT is attempting to persuade GPs to accept a reworked PMS contract, including a proposal to link 4% of practice funding to practice-based commissioning performance.


Dr Ross Worthington, a GP in Haverhill and one of 46 PMS practices being represented by Suffolk LMC, is among those taking to the streets to protest at the weekend at PCT proposals he says amount to ‘more work for less money'.

He said: ‘We are looking at a loss of £300,000 over five years – or 15% of the total budget for the three practices in Haverhill.'

Disputes over contract pay-ments are also raging in other parts of the country including Barnet, Northumberland and Nottingham.

Dr Peter Yeoman, chair of Northumberland LMC and a GP in Blyth, confirmed his LMC was involved in discussions over ‘clawback' payments with the local PCT on behalf of local PMS practices. But, as in Suffolk, talks with the PCT have broken down.

GPC chair Dr Laurence Buckman said that, for many PCTs, pursuing claw back payments was an ‘essential instruction' this year. He urged practices to seek advice from their LMC ‘if they are being coerced'.

Dr Ross Worthington is among Suffolk GPs taking to the streets over PCT cuts which will wipe hundreds of thousands of pounds of PMS surgeries' income Dr Ross Worthington is among Suffolk GPs taking to the streets over PCT cuts

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