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GPC chair considering move from PMS contract amid fears over NHS England review

The chair of the GPC has said he is considering relinquishing his PMS contract amid fears that a controversial review by NHS England will ‘inevitably’ lead to practices moving over to GMS.

Pulse reported this month that PMS practices are facing £260m of their funding being ‘redeployed’ over the next two years as as result of the review, leading proponents of the contracts to question their viability in the long run.

GPC chair Dr Chaand Nagpaul told Pulse that he is considering moving to the GMS contract himself as the PMS contract is leaving his practice with fewer pounds per patient than similar practices on the standard contract.

Meanwhile, Merseyside GP Dr James Kingsland, who was the Department of Health’s clinical adviser when PMS was first drawn up in 1998, told Pulse there was no reason he remained on his PMS contract.

The comments come at a time when the number of PMS practices is already in decline, with the Health and Social Care Information Centre recording the demise of 45 PMS contracts in 2012. In the same year, average income of a GP on a PMS contract fell by 1.6%, compared with just 0.7% for GMS GPs.

From April, area teams will be setting out on a two-year process to review £260m worth of ‘premium’ funding to PMS practices, which an NHS England fact-finding mission found was not directly linked to extra services to patients.

All practices will also be placed on a national template PMS model contract.

Dr Nagpaul said: ‘It is inevitable that some practices will switch to GMS, because for those on the lower end of the scale it will make little sense to remain PMS if reverting gives them the equivalent, or in some cases even better, level of funding.’

‘Because this would see practices returning to a GMS funding with an MPIG average, this I think would make it more feasible for many practices [to switch].’

The north London GP added: ‘To be honest it is something that I would consider for myself for my own practice. We are a very low-funded PMS practices – there are GMS practices with more pounds per patient.’

But Dr Kingsland said the rolling ‘value-for-money’ reviews of PMS contracts undertaken by PCTs with a ‘one-size-fits-all-approach’ since 2006 have already put the nail in the coffin of the contract model, which was originally designed to deliver better primary care based on local needs and thus keeping people out of hospital.

He said: ‘I don’t know if I missed the passing of PMS. You ask why we are still a PMS practice? The answer is “I don’t know”. There is a sense that the whole focus of PMS is gone.’

The GPC fears that the PMS review will be used to take money away from GPs and put into other holes in the budget.

Dr Nagpaul said: ‘We hope that area teams will be fair in their process and not use PMS as a “soft target” [but] are worried that area teams will take this money away and use it to plug other gaps.’

‘We believe that this money should be redeployed to GP surgeries and should not be used for other purposes, like offsetting deficits in other parts of the budget.’