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CCG considers returning PMS funding to practices with ‘atypical’ populations

Exclusive GP practices that lost funding during the national PMS review may now have this reinvested, after local commissioners in one area identified they had ’atypical’ populations.

NHS Northern, Eastern, Western (NEW) Devon CCG told Pulse that two practices which lost funding in PMS reviews were now among those identified as potential candidates for the reinvestment of PMS funding.

This follows a piece of work with local public health teams to identify practices with an ‘exceptional population with additional needs that are not recognised by the Carr-Hill formula’.

The work is in early stages but the practice populations identified as requiring further investigation had included large numbers of refugees or asylum seekers, and a larger proportion of students.

Future work will continue to determine evidence of additional need and appraisal of appropriate reinvestment, with the final report set to be published in November 2016, the CCG said.

It was also awaiting the review of the Carr-Hill formula which the GP Forward View recently pledged would be completed by the end of summer 2016 with a view for implementing it next year.

The national review of PMS contracts was intended to ensure PMS practices only received extra funding for services they were providing, but many affected practices had said the review did not consider non-core work they were providing routinely, or the pressure of their local populations.

The ‘atypical’ practices and populations identified by NHS NEW Devon CCG as needing further investigation include Peverell Park, Beaumont Villa and St Thomas (student practices), as well as Cranbrook Medical Centre (new town) and Beaumont Villa surgery (refugees).

A spokesperson for the CCG told Pulse this was one part of the process ‘for defining areas for reinvestment of the PMS Premium for 2017-2021.’

They added: ‘All PMS Premium monies will be reinvested in general practice (as per the guidance). Two of the practices listed had a reduction [following a PMS review] as they were above the equity point, in relation to their contract value.

‘The final report is not expected till November 2016. At that point the Primary Care Committee will then decide about any potential investment in the financial years 2017-2021.’

NHS NEW Devon CCG declined to comment on which of the four practices had lost PMS funding during the latest reviews but both Peverell Park and Beaumont Villa surgeries hold PMS contracts.

Pulse has previously reported that practices with atypical populations – such as rural practices and those treating high numbers of homeless people – could be given their own contracts under plans being discussed by GPC and NHS England.

Devon LMC declined to comment, but commenting on PMS practices having money withdrawn then returned, Birmingham LMC executive secretary Dr Robert Morley said: ‘It [goes] to show how absolutely bonkers and unfit for purpose the whole system is.’

PMS review blues

NHS England identified that PMS practices were paid, on average, £13.52 more per patient than GMS practices, some of this ‘premium’ funding was linked to specific enhanced services but £258 million had no formal link.

Following the reviews, practices have seen premiums of as much as £227,000 a year stripped from their practice budget, triggering legal challenges in some instances. But NHS England guidance had specified CCGs had to reinvest all of this funding into local general practice.

Pulse was able to reveal last month that almost a quarter of PMS practices have switched to GMS in light of the national review, with CCGs redistributing their premiums into things like new schemes to boost access, increase e-referrals or boost elderly care.