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Trusts force cost cuts on PMS GPs

By Helen Crump

PCTs are turning the screws on PMS practices as part of a

Government-inspired attempt to wring greater value for money out of local contracts.

PMS GPs have reported being told to take on extra work with no additional funding and given new targets as part of mid-year contract renegotiations.

The moves come in response to a Department of Health diktat in March instructing PCTs to 'deliver improved efficiencies' from PMS GPs and ensure equivalence with GMS practices.

The department also announced in its White Paper Our Health, Our Care, Our Say that it would conduct a 'fundamental review' of PMS.

PMS GPs earn on average around 10 per cent more than GMS, but are increasingly bearing the brunt of spending cuts.

GPs in Reading said they were facing a number of new targets, including an expectation to hit Red Book targets on cervical cytology without being allowed to exception report.

Dr Ian Jacobs, a PMS GP in Reading, said GPs were 'fed up' that the trust was trying to impose changes mid-year.

He said: 'There are various threats beginning to be bandied about that if you can't show what you're achieving is significantly different to an average GMS practice then your costs will be squeezed.'

Dr Paul Roblin, chief executive of Thames Valley LMCs, said PMS practices were in a difficult position and would have to 'think carefully about how PCTs might react' if they tried to fight the moves.

He said: 'It might be beneficial to agree some things that are more onerous than GMS to justify PMS pounds per patient.'

In Leeds, PMS GPs have been asked to select extra services, such as weight management, alcohol intervention and osteoporosis screening, they will take on from a list drawn up by PCTs.

Dr Richard Vautrey, GPC negotiator and secretary of Leeds LMC, said practices should have been asked to put forward proposals rather than told to choose from a list.

Dr Vautrey added the GPC was aware of similar moves happening nationally.

He said: 'I think that needs to be done very sensitively and with good understanding of what the practice was given the growth money for and how they have used it over a number of years.'

A department spokesperson said it was still collecting evidence for the PMS review.

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