NHS England regional teams and CCGs have been told to plan how they will redistribute money made from cuts to PMS contracts before making the cuts.
Reviews of all PMS contracts were supposed to be concluded across England by 1 April but some have been delayed.
Under the terms of the review, agreed by NHS England with the GPC, area teams were told to establish how much of the extra funding given to PMS practices was not linked to extra services.
This money would then be redistributed to general practice within the CCG area.
But now NHS England has issued a clarification to NHS England regional teams and CCG leaders to say they should prioritise the reinvestment plans before making cuts, in order to offset concerns amongst PMS practices losing funding.
In the letter, sent 16 May, NHS England director of NHS commissioning Rosamond Roughton said PMS practices were ‘understandably’ concerned about their funding reducing where they were not clear on reinvestment proposals.
The letter said: ‘We have been clear on the need to ensure PMS practices can plan for the net impact of these funding changes by ensuring any funding reductions can be set against local proposals for reinvestment.
‘However this communication of new earning opportunities is not happening universally in all areas and PMS practices in those instances will understandably be concerned.’
She said NHS England is ‘therefore requesting that all local commissioners ensure these reinvestment proposals are confirmed locally to PMS practices before any actual reductions to funding are made to PMS practices who are facing reductions in funding’.
In repsonse, Ms Roughton said the ‘immediate priority’ of commissioners ‘should be on confirming reinvestment plans for 2016/17 and, where possible, 2017/18’.
She said: ‘This information should be made routinely available to PMS practices for the period of time PMS review funding changes apply.’
The letter added that it was ‘important that any funding changes are managed in a way that does not risk destabilising general practice’.
But there have been reports that PMS reviews have already destabilised practices. For example:
- Four senior partners at a Sunderland practice rated ‘outstanding’ by the CQC have been forced to quit after an NHS England PMS review saw funding for the surgery cut by £400,000.
- NHS England is facing a potential judicial review in the wake of PMS review cuts to a local practice near Huddersfield that will mean a 42% reduction in its annual budget, leading to redundancies and reduced access.
- Patients of a GP practice in Norfolk are considering joining a ‘class action’ legal challenge against NHS England over PMS funding cuts. Patients of the practice, set to lose £550,000 in PMS contractual funding, have also secured a meeting with a health minister.