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PMS practices given reprieve as CCGs delay reviews

Exclusive PMS practices in some areas where CCGs are taking over the commissioning of general practice are being given a reprieve as commissioners have delayed potentially destabilising reviews of their contracts until 2016, Pulse has learnt.

CCGs in the Thames Valley area – who have applied to take on a greater role in commissioning GP services under co-commissioning plans – have expressed concerns at the timescale for the withdrawals of PMS funding proposed by NHS England, and are opting to defer in order to avoid ‘de-stabilising’ practices when they’re already under pressure.

They have said they would be use the extra time to assess how any funding recouped from PMS premiums should be spent locally as one of their first actions when they are given responsibility for managing primary care in April.

The pace and scale of PMS reviews – designed to ensure PMS practices only received extra funding only for services they were providing – had originally been left to area teams’ local discretion.

But in September, Pulse revealed that NHS England had issued teams with policy options for them to ‘follow’ after major ‘inconsistencies’ were found in how reviews were being conducted.

In November, PMS practices in the Thames Valley area were offered a range of options, including undergoing an area team review or a gradual transition on to the GMS contract, and were given a deadline of 31 January to sign up.

This was similar to schemes already underway in East Anglia and Essex, which have had widespread uptake as practices seek to minimise the impact of lost PMS premiums.

But before Christmas NHS England Thames Valley director of commissioning Helen Clanchy wrote again to PMS practices saying that the reviews had been postponed at the request of CCGs.

NHS England Thames Valley had said: ‘As part of CCG involvement in co-commissioning, Thames Valley CCGs had requested that timescale of the review be extended to March 2016 to give time for CCGs to assess the added value of PMS and any local use of released PMS premiums.’

In Berkshire, a spokesperson for Berkshire West CCGs, which cover four CCGs and 25 five PMS practices, including 24 in Reading and one in Newbury, told Pulse: ‘[We] are in discussion with Thames Valley area team to postpone all PMS reviews until March 2016.

‘We and our member practices are concerned about the timescales that were originally proposed; to begin to recover funding from April 2015 could de-stabilise practices at a time when the primary care system is already under considerable pressure.

‘We’re keen to see that any timetable mitigates this risk and allows sufficient time for the case-by-case review of contracts described in the national guidance.’

Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire and Oxon LMCs, told Pulse that he hoped CCGs would take the funding of already overstretched GP services ‘very seriously’ when considering how funding is allocated.

Dr Roblin said: ‘There’s no doubt that it’s going to be very difficult to get the core GP contract, pounds per patient increased, and whenever you have dialogue about doing that, [NHS England] say you should go to your CCGs for funding. If that is the avenue we’re obliged to take, then I want CCGs to take the funding of general practice seriously.’

Last year, NHS England chief executive Simon Stevens promised CCGs would be able to co-commission primary care alongside NHS England, either through greater discussion, jointly holding budgets with NHS England, or taking delegated responsibility for primary care services.

Pulse revealed this month that almost half (42%) of CCGs opted for the third option, which includes management of GP contracts, as well as handling premises, enhanced services and local QOF schemes, while NHS Bolton CCG has said it will ensure all practices receive a minimum of £95 per patient for meeting certain indicators when it takes on the commissioning of primary care.

NHS England Thames Valley area team was approached for comment but did not respond in time for publication