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PMS could ‘disappear’ as GPC begins single contract talks with Government

A single GP contract could become a reality before the end of the coalition Government’s term, the GPC chair believes.

In an exclusive interview with Pulse, Dr Laurence Buckman confirmed that early stage negotiations with the Government on how to achieve the target of a single GP contract, first set out in the Government’s 2010 health white paper, had begun.

Dr Buckman said the assumption at present was that the new single contract ‘will look like GMS’, indicating that PMS could be subsumed. But he said it was too soon to say exactly what the model would look like.

The plans would affect approximately 40% of GP practices in England, which are currently operating under locally negotiated PMS deals.

The talks are not expected to affect APMS contracts, which allow PCTs to contract with alternative providers under local commissioning arrangements.

PCTs across England have faced criticism from GPs for slashing local PMS budgets in a bid to save costs, with LMC leaders in Birmingham last month forcing managers to give GP practices a chance to justify the additional services they provide after they threatened to unilaterally terminate all local PMS contracts with six months’ notice.

Dr Buckman said: ‘If we could make it work so it was financially fair and operationally reasonable, then [a single contract] is what we would like to see. Whether PMS will disappear into GMS I don’t know, I don’t think we can judge that yet, but I think the new GMS contract has a lot to commend it and I would like to see it continue.’

He said the complex process to merge two contracts into one could possibly take years and will require extensive advice from economists and lawyers.

‘We are at the beginning of a very complicated process. Even if everyone was willing to do something, the actual move of one thing from one place to another is very complicated. We would really like to do that very carefully to make sure no practice is damaged as a result,’ Dr Buckman said.

‘I don’t think it is going to happen suddenly, and certainly not in the next few weeks or months. I think it is going to take a lot of time before we get this right, but I believe it is worth doing.’

A Department of Health spokesperson said: ‘Developing a single contract for GPs is part of our plan to provide a consistent quality of care for patients and fairness for all practices.

‘This was outlined in July 2010 in our white paper Equity and Excellence. Negotiations are ongoing and any legislation will need to be approved by Parliament.’

Dr Jane Lothian, a GP in Ashington and medical secretary of Northumberland LMC, who works under a PMS contract, said: ‘The new GMS contract looks very much like the PMS contract that we negotiated in the late 1990s. I still think there should be room for local flexibility if there is one single contract.

‘It is time for change and I would welcome any change to the contract, which I think has become too fragmented and is no longer acting in the best interest of patients. If we are creating a new GMS contract, I think there is lots of room for improvement.’