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NHS bosses plot to prevent PMS GPs getting GMS uplift

NHS managers have drawn up secret plans to stop PMS GPs from getting the 2.29% pay award agreed for their GMS colleagues today, unless they take on additional work, Pulse can reveal.

The Doctors' and Dentists' Review Body announced a figure which it said would result in a 1.5% net increase in pay for GMS practices.

But PCTs have already been told not to pass on an equivalent increase to the 42% of practices - and 47% of GPs - who work under PMS contracts.

Instead, the NHS wants trusts to demand better value for money before awarding any contract uplift.

Pulse revealed in December that PCTs were preparing a major clampdown on PMS contracts, with two-thirds seeking to obtain better value from local contracts.

But a document uncovered by Pulse, dated March 2009, demonstrates that managers are now stepping up moves to drive efficiency.

Trusts have been told to keep a squeeze on PMS funding from the public or to spin it to avoid criticism from the media.

A briefing drawn up by the Government's policy advisory body, NHS Primary Care Contracting, , told PCTs: ‘As DDRB awards are only mandatory for GMS practices, PCTs may wish to model the impact of differential DDRB uplifts for PMS practices and to tie in this work with any forthcoming PMS reviews.

‘PCTs may wish to understand what added value they get from PMS compared with GMS before agreeing uplift with PMS.'

The guidance tells managers to ‘link any uplift to the completion of a PMS review, incorporating World Class Commissioning competencies with a particular focus on value for money.'

PMS GPs in Suffolk – who were involved in a high-profile dispute over contract last year – are now facing the prospect of having to take on leg ulcer treatments, increases in their opening hours and minor surgery services in order to receive a pay uplift.

Dr Jim Sherifi, a PMS GP in Sudbury, Suffolk, told Pulse: ‘From my understanding the PCT now wants to bring a load of extra services into general practice, with the money attached being for an uplift, not for the extra services.

‘They are quibbling over all sorts of things and arm-twisting in a way that is demeaning for both sides.'

The crackdown on PMS GPs has split leading GPs.

Dr Prit Buttar, chair of the GPC's Practice Finance Subcommittee, said: ‘There may well be some PMS practices which are getting extra money without doing much work but I suspect equally there are loads who work very, very hard for their money.

But Dr Michelle Drage, joint chief executive of Londonwide LMCs, said: ‘We shouldn't hide from the fact PMS practices by and large do have a higher payment per patient.'

NHS guidance to PCTs on how to handle PMS negotiations

• Put a positive spin on this to counter-act negative messages
• There is a risk patients registered with losing practices will be targeted by their GPs with adverse ‘noise' e.g. "our funding has been cut, so we have to sack our nurse or stop this service"
• Consider lessons learned from extended hours, in terms of using local publicity to counter resistance from local GPs

Source: NHS Primary Care Contracting

PMS clampdown: nearly half of GPs will not get the uplift of their GMS cousins if NHS money men have their way PMS clampdown: nearly half of GPs will not get the uplift

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