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NHS managers backtrack on vow that all new GP contracts will be APMS



Exclusive NHS England has watered down its policy that any new GP contracts ‘should all be on APMS’ , after Pulse highlighted its position as part of the Stop Practice Closures campaign.

After pressure from the GPC, NHS England told Pulse said it would review practice closures on a ‘case-by-case’ basis, rather than the previous blanket policy of using APMS for all new GP contracts as ‘best practice’.

The GPC has welcomed the change, saying it was a ‘better position’, but added it would only make a difference when it is put into action.

The revised position comes after the GPC wrote to NHS England challenging the legality of its policy to only award APMS contracts, except in the case of a PMS review or a PMS practice reverting to GMS.

GPC chair Dr Chaand Nagpaul warned that putting all new GP contracts out to procurement would ‘destroy the fabric and ethos of general practice, and throw open the door to private providers running general practice on a commercial basis by remote control’.

A Pulse investigation had revealed that local leaders have have been approached by more than 100 practices are considering closing as a result of funding issues or problems recruiting partners, leading Pulse to start the Stop Practice Closures campaign.

Following the GPC’s intervention, Pulse had asked NHS England to clarify its position, and it said it was ‘continuing’ to review on a case-by-case basis.

Its statement said: ‘NHS England has not made a decision to end the use of GMS or PMS contracts.  We continue to review on a case-by-case basis depending on local circumstances.

‘A practice closure may arise as a consequence of a range of factors. NHS England has a responsibility to secure high quality general practice for all patients affected. Depending on local circumstances, area teams will explore the most appropriate option, and in so doing, will frequently seek legal advice to ensure that process is in line with relevant guidelines and regulations.’

However, despite numerous requests from Pulse, NHS England would not comment on whether it had reversed its position.

GP leaders said this did look like a revision, and said its new policy was a ‘better position’.

Dr Richard Vautrey, deputy chair of the GPC, said: ‘It is clear that NHS England can (and should) use GMS and PMS contractual options for new practices. The evidence is also clear that these options provide the highest quality service to local patients. Trying to make short term cost savings through the use of APMS has often led to longer term bigger cost implications and is why so many CCGs have terminated contracts locally.

‘[This] is a better position but it will only make a difference when we see it put in action.’

It comes as a health minister last week revealed that there had been 518 practice closures over the past five years.