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The GP architect of PMS has revealed plans to 'relaunch' the contract as a radical alternative to GMS.

Dr James Kingsland, a former Government adviser on PMS, said there was 'no point' in the local GP contract continuing unless it had a 'very different focus' from GMS.

The flood of GPs moving to PMS has halted since the Government stopped offering thousands of pounds in growth money to practices wanting to switch. Numbers are now at around 37 per cent.

With most PMS practices working to the GMS quality framework, the two contracts have become almost indistinguishable.

Dr Kingsland said the National Association of Primary Care, of which he is chair, was drawing up a skeleton for an alternative quality framework as part of a plan to 'galvanise' PMS GPs.

Practices could adapt the framework to their own needs.

Dr Kingsland, a GP in Liverpool, said PMS needed to be about innovation and alternative clinical services, rather than chasing money. He said: 'There has been a lot of talk about money in PMS, but not clinical services. Not much has happened in that area.'

The NAPC is also to set up a forum for PMS GPs to reveal problems in their region. Dr Kingsland said the association would then lobby ministers over the issues.

'The NAPC supports contractual variety and the local nature of PMS but where there are consistent problems we can take them to the Department of Health,' he said.

GPC chair Dr Hamish Meldrum, also a PMS GP, warned it would be politically difficult to have national consultation for local contracts.

But Dr Derek Hopper, chair of the PMS doctors' committee at the BMA, welcomed the proposals. He said PMS practices had been distracted by taking on the GMS quality framework.

Practices with large numbers of homeless patients, asylum seekers, university students or drug misusers were prime candidates for PMS and would be suited by a more 'liberal' QOF, he added.

Dr Chaand Nagpaul, a PMS GP in Harrow, Middlesex, said he doubted the relaunch would be backed by GPs who switched contract simply for the extra money.

'You can't have it both ways,' he said.

By Ian Cameron

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