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PMS practices face redundancies and closures due to ‘catastrophic’ cuts

Exclusive: PMS practices are planning redundancies and some could even be forced to close by a ‘catastrophic' wave of contract reviews that will see five-figure sums stripped from budgets next year.

GPs across London, Staffordshire and the North West are among those targeted, with one PCT planning to squeeze up to £2m in QIPP savings from PMS budgets next year, and a practice elsewhere claiming it stands to lose £200,000.

The cuts follow a claim from GPC chair Dr Laurence Buckman in January that the ‘writing is on the wall for PMS', and come nine months after legal experts warned PMS practices faced a ‘precarious' future after a landmark High Court judgment gave PCTs the power to force GPs to accept unilateral PMS changes or face contract termination. PMS contract reviews are increasingly leading to legal challenges, with the NHS Litigation Authority revealing it handled a record nine disputes regarding PMS variation or termination in 2011/12 – three times the number in 2010/11.

In London, 39 PMS practices in Southwark face an average cut of more than £50,000 to their income after managers launched a PMS review designed to save £2m in 2012/13.

PMS practices in Staffordshire have launched appeals against a contract review which aims to cut £800,000 in funding from the cluster's 73 PMS practices next year.

Dr Paul Scott, chair of North Staffordshire LMC, said: ‘The [PMS review] could have a considerable impact on some practices, with 5% budget reductions per year until achieved. This will cause redundancies in some practices.'

Elsewhere, NHS Oldham's 2012/13 financial plan reveals the ‘fruition of a PMS review' will contribute to a targeted £1m in primary care savings next year.

And NHS South West London cluster said it was reviewing PMS deals to improve the ‘equity' of GP contracts, with affected practices claiming the shake-up could remove almost half their income.

Beverley Snell, practice manager at the Vineyard Hill surgery in Wimbledon, told a meeting of Merton Council her practice would lose £200,000 – 43% of its income.

Dr Jill Provost, a GP at the same practice, said: ‘These losses are unsustainable. It is difficult to see how the practice could survive.'

A spokesperson for NHS South West London said: ‘The Vineyard Hill practice has been receiving more per patient than the average and does face the prospect of reduced income. We appreciate the challenge this presents and the PCT has established a year's transitional relief.'

Dr Chaand Nagpaul, GPC negotiator and a PMS GP in Stanmore, described the national cost-cutting drive as ‘a very short-sighted approach'.

Dr Jane Lothian, secretary of Northumberland LMC, said her LMC had fought to protect PMS practices from the worst impacts of cuts, but warned: ‘Unless there is a political will to keep PMS, I very much doubt that it has a future. Cuts of 5-10% are a considerable hit.'

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