Exclusive A Pulse Intelligence analysis has revealed that APMS practices receive almost £18 a patient – or 14% – more than their GMS counterparts.
The analysis on income data in England showed that PMS practices continue to receive more than GMS practices, but the gap in funding between GMS contracts and APMS/PMS contracts is narrowing compared with two years ago.
It also revealed that funding per patient increases the smaller a practice is, while practices in rural areas receive around £10 per patient more than those in urban practices.
Pulse Intelligence’s calculations also showed that practices that received MPIG funding in 2015 were funded far less per patient in 2020/21 than those that didn’t.
The analysis is based on the ‘Payments to general practice’ data from NHS Digital, stripping out data on premises, dispensing fees and locum reimbursements as they provide a distorted picture, and it doesn’t include the data on Covid support, which covers reimbursement of expenditure.
Once these funding pots are taken out, it shows an increase in funding from £127.58 to £131.78 per patient.
When Pulse Intelligence ran a similar analysis in 2019, it revealed that the gap between GMS and APMS practices was £40 per patient, while the gap between GMS and PMS was £6 per patient.
Dr Katie Bramall-Stainer, chief executive of Cambridgeshire LMC, says these figures are ‘yet more evidence demonstrating the value for money to be found from GMS’. She adds: ‘It’s a pity we have spent the past decade playing successive three card tricks with ever smaller pots of money at the end of ever longer hoop jumping exercise. How much more sense would it be to simply commission high quality, higher spend GMS – anything else is simply a false economy.’
Dr Michelle Drage, CEO of Londonwide LMCs, said: ‘APMS contracts cost 14% more than GMS, yet the large providers who take them on operate on a profit/loss model, handing contracts back to NHS England after a short period of time when the contract becomes too challenging, which is bad for patients’ continuity of care and bad for GPs and staff. Our patients deserve better.’
She added: ‘The best way to improve care is to invest in the funding of core general practice so that GPs and practice teams can use our unique understanding of the communities we care for to meet patients’ needs in the best ways we can.’
Andrew Pow, board member, Association of Independent Specialist Medical Accountants and healthcare partner at Mazars, says: ‘This analysis is on income only, not earnings after expenses. It also excludes the majority of locally funded schemes which have significant geographical variances. Integrated Care Systems (ICSs) may challenge practices where the aim is for funding to be level across an area.
‘The increase in income was reflective of the overall increase in funding negotiated by the BMA. The figures in this analysis represent a 3.3% increase, but inflation is now running at 4% and some costs have increased so this does not directly translate into profits. For example, pay rates for salaried GPs increased by 2.8%.’
Dr Farah Jameel, BMA GP Committee chair, said: ‘While different funding streams are designed to reflect the broad range of services practices provide and take into account to a certain extent differences in patient demographics and practice locations, what is clear at the moment is that current levels of resourcing do not reflect the current workload and workforce pressures practices are experiencing. Nor do they take account the wider system pressures that are impacting upon general practice.’
Methodology
The raw data were from NHS Digital’s publication Payments to General Practice 2019/20. We included network DES participation fees, but no other PCN funding (including Covid vaccination payments). To give meaningful comparisons, we removed practices with ‘atypical characteristics’, as defined by NHS Digital, and practices with fewer than 1,000 patients. We removed funding for premises, dispensing costs, and reimbursement of drugs, locum fees and Covid support fees. All calculations were on a per-registered patient basis
For full analysis of all the data, visit the Pulse Intelligence website. PI is set to relaunch this month, with a new look and layout to make it easier for practices to identify areas where they can increase funding and expert guides to help them do so. Visit www.pulse-intelligence.co.uk for a free trial
READERS' COMMENTS [2]
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Divide and conquer!
A Pulse Intelligence analysis has revealed that APMS practices receive almost £18 a patient – or 14% – more than their GMS counterparts.
How else can a private company extract profit and value of 15-20% from each contract when they themselves provide no function or value, and just suck out the life blood of the NHS.
Only by paying them more than the rest of general practice, NHS England allows the unfair and un-evel playing field to exist to allow private companies to thrive in the NHS. They take the additional funding as profit and leave any contract where they don’t get value for shareholders, and never does the DOH or NHS England hold them to contracts not in their financial benefit, nor do they have any consequences for leaving patients in the lurch, as they continue to be allowed to bid for and are awarded future contracts.
Instead of fighting and turning practices around and sticking with contracts and commitments made, they turn tail and leave, or fold or merge their parent companies.
The extra money also allow them to outbid and pay salaries to their staff higher than everyone else, again destabilising the practices around them as they poach staff, other have spend time developing and training, as they can’t match the salaries offered.
All GP contracts should be paid the same basic rate, and should be uplifted such that MPIGs are not needed, and it is a level playing field for all, not just the mates and donors of the politicians in power.