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NHS England to award ten-year £100 per patient APMS contract

An NHS England area team is looking to award a ten year APMS contract, valued at £100 per weighted patient, despite local GP leaders’ concerns, Pulse has learnt.

The Kent local area team has put an invitation to tender out for the contract for the Martello Health Centre, valued at £342,691, which had a patient list of 2,699 as of July 2014, of which nearly 40% are over 60.

It is unclear what additional services the practice will have to provide, but Kent LMC has warned the local area team that such a contract could give the practice an unfair advantage over neighbouring practices in the area, and stress that other no other practice receives this level of funding.

The LMC’s October newsletter states: ‘NHS England area team have issued prospectus and an invitation to tender for a 10 year APMS contract where there is currently a single handed vacancy, valued at £100 per weighted patient.

The LMC told Pulse that the area team hadn’t yet specified exactly what services the practice would be expected to provide, and Pulse was unable to obtain further details despite numerous requests.

The service currently provides routine opening hours and is being run by locum cover and practice staff who have been retained after the original, single-handed contract holder retired.

The Memorandum of information for the contract states: ‘The aim of the service is to deliver essential, additional and enhanced services to registered patients from premises located in Dymchurch.

‘As of 1st July 2014, the registered list size was 2,699 patients, with a normalised weighting of 3,426.91 patients.

‘The positive weighting reflects the higher than national and CCG average number of patients aged 65 and over registered with the practice.’

Pulse recently revealed that NHS England had issued its area teams with directions not to procure new GMS or PMS practices and to only use APMS contracts, though it subsequently reversed this stance following GPC pressure.

Kent LMC medical secretary Dr Mike Parks told Pulse that he sympathised with the problems the area team faced in attracting providers, but added: ‘We are concerned about contracts being placed that give a competitive advantage to one practice over their neighbours.

‘And equally we think that if the area team are saying “this is what primary care is worth”, why aren’t they saying “well this is what we should be paying all of primary care”?’.

‘I understand why it’s difficult to recruit people to take on new contracts, but that’s the case everywhere. Obviously, this particular practice is in a very rural area, and is a relatively low list size. Which of course makes it even more difficult to be financially viable.’

‘But the neighbouring practices, Dymchurch on Romley Marsh, obviously face some of the same issues and problems that the Dymchurch practice does.’

Dr Parks added: ‘Additional services at the moment are not defined, they are talking about some KPIs (Key Performance Indicators) over and above what’s in the standard GMS contract. But we don’t actually know what those will be.’

Dr Robert Morley, chair of the GPC’s contracts and regulations subcommittee, said he could not comment on specifics without knowing exactly what the contract holder had to provide.

But he told Pulse: ‘I would be surprised if any contracts were incredibly overgenerous compared to GMS and PMS, but if it does seem too incredibly generous, then local practices should get their act together to try and bid for it themselves.’

‘It’s not easy, but if practices can organise themselves into larger entities then they can be in a position to bid. And that’s increasingly what practices are going to have to do because they’re in as competitive market place now.’

This is the latest example of APMS practices being paid more than the global sum, after Pulse revealed in 2008 that some APMS practices were being offered £186 per patient.

Readers' comments (17)

  • Let's look at it from a different perspective. I have a Surgery with 4150 patients - weighted 3600. The total amount paid under GMS Contract via Open Exeter for year ending 31.3.2014 was 259000 excluding rent for the premises.
    Apart from the 340000 offered to this APMS Provider, there are KPIs for which Kent APMS Contractors can get anything from 65000 annually.
    Worth noting, it hasn't been disclosed what these KPIs will be worth for this Practice.
    KPIs include things like smoking cessation advice, alcohol advice etc and lots of thing for which GMS Practices have no additional payments as they are already in their Contracts.
    It certainly is an unfair advantage but then transparency is what we lack in the system.
    Did anyone count the cost of the tendering process? NHSE is getting us value for money by burying the NHS as deep as it can get.

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  • These are figures for some APMS Providers in Kent/Medway
    FOI 13.01.2012 and the offer to Marlowe Park Medical Centre. The Practice had an APMS Contract for a year and was successful in fighting off a closure attempt regaining the GMS Contract albeit without the MPIG.

    Practice Quarter Patient List Size 2010/11 £
    Malling Health 31/03/2010 7153 901,486
    30/06/2010 7261
    30/09/2010 7133
    31/12/2010 7159
    31/03/2011 7159
    DMC Walderslade Surgery 31/03/2010 328 565,201
    30/06/2010 635
    30/09/2010 939
    31/12/2010 1182
    31/03/2011 1527
    Dulwich Health Medical Centre 31/03/2010 1833 2,472,410
    30/06/2010 2307
    30/09/2010 2789
    31/12/2010 3170
    31/03/2011 3525
    College Health - Boots 31/03/2010 1758 489,048
    30/06/2010 1935
    30/09/2010 2493
    31/12/2010 2820
    31/03/2011 3088
    College Health 31/03/2010 1687 470,595
    30/06/2010 1901
    30/09/2010 2059
    31/12/2010 2067
    31/03/2011 2046
    Marlowe Park 3446 220000
    proposed to be reduced by MPIG to 192000 if KPIs
    not fulfilled.

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  • At least these APMS contracts can be held by limited companies.
    That is a huge advantage - 1 LTD co per contract, if things get tight in a few years turn in the contract, wind up the company or threaten this and get a fat bail out.

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  • Transparency means giving all the details open. Does NHS England do things transparent? Will any private providers apply for this sum of money? We have to wait and see

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  • If private providers do not appear then NHS England has the option of dispersing the list . Then the local poor suckers get to take on these patients at a much lower GMS tariff .

    The local GPs have no choice but to take these patients on, with the significant risk that their own practices will be destabilised and they could go bankrupt or lose their sanity.

    For the sake of these poor doctors the BMA should start behaving like a union.

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  • @1:38 - Waited for 9 long years for the BMA to start 'behaving like a Union'. Resigned membership last month as it seems to be more of a mutual adoration club enjoying champagne and caviar at members expenses.

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  • I wouldn't get myself locked into any contract with NHSE, hopefully the next government will get rid of them along with a few other useless departments!

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