The NHS Commissioning Board is set to review all PMS contracts with the view for all practices to be paid the same baseline funding per patient by 2021.
The DH has expressed a commitment to retaining the PMS contract as a concept, with practices still eligible for extra funding on top of baseline funding for offering additional services.
But the DH wants to eradicate any ‘inequalities’ in basic funding and intends for all GP practices, whether on a GMS or a PMS contract, to have the same core funding arrangement after the seven-year transition period.
The PMS contracts are agreed locally with extra funding distributed to practices based on providing services that address special needs of their local population. They are currently held by PCTs but will be held by the NHS CB from April 2013.
The GPC has agreed in principle to discuss a move towards reducing variability in contract funding but Dr Chaand Nagpaul, a GPC negotiator and a GP in London, warned that the Government’s plans must be carefully reviewed.
He said: ‘We need to really understand exactly what the Government proposes for PMS. I would be very worried if the Government took the extra money from PMS practices and removed it from the overall funding of GP services. It is all very well and good to talk about reducing inequalities but what happens to this money when it is released? These are huge questions.’
However, the DH position has stoked some fears expressed by the National Association of Primary Care, which had said it would vigorously fight to keep the PMS contract safe. It initially raised concerns after the DH used ‘vague’ language in October that indicated the PMS contract could be in danger.
However NAPC chair Dr Charles Alessi commented today: ‘I am not sure what it means exactly, the devil will be in the detail. There is an awful lot to discuss until we come to 2021, but it is also worth noting that it is over eight years away [and] it is inconceivable that primary care will even look the same.’
‘But if your question is “am I encouraged” then the answer is yes, because really we have won the argument for a locally-agreed contract. It is encouraging that PMS as a concept still has a value and is not going to cease.’
At the same time, GPC has criticised PCTs for still going ahead with renegotiation of PMS contracts despite the impending overhaul. This includes GPC member and Birmingham LMC secretary Dr Bob Morley’s local area, where the Birmingham and Solihull cluster is pushing ahead with a blanket renegotiation of all local PMS contracts, with most of the new arrangements set to go live from April.
Commenting ahead of the release of the DH plans, Dr Morley said: ‘It would be lunacy for PCTs, which are going to disappear very soon anyway, to continue with a destructive local process that might soon be overtaken by a national imposition. However, we have already done our best to make our PCT cluster see sense, but this is proving way beyond our best endeavours.’