£325m PMS funding premium figure unreliable, GPs warn

GP leaders have questioned the accuracy of PMS funding data that underpins plans to equalise pay for practices across England.

Dr Peter Smith: concern over PMS review
Dr Peter Smith: concern over PMS review

An NHS England review found that GP practices on PMS contracts receive £325m in total more than they would for the same services under a GMS contract.

Around £67m of this funding ‘premium’ was found to be linked to identifiable enhanced services or key performance indicators (KPIs), a letter from NHS England to its area teams said this week.

The remaining £258m ‘may be associated with enhanced services or populations with special needs, but is not defined’, the review found.

The review has sparked fears that more than £200m could be stripped from PMS funding and lost to general practice as the NHS looks to level out funding across GMS and PMS contracts.

But Londonwide LMCs medical director Dr Tony Grewal told GP he was not convinced that the £325m identified by NHS England was genuinely ‘premium’ funding.

‘The figures are very suspect,’ he said. ‘Unpicking value for  money from PMS contracts is incredibly difficult.

‘If they redistribute funding they will be at best exchanging one set of inequities for another.’

Northumberland LMC chairwoman Dr Jane Lothian said: ‘I am very cynical – when previous administrations looked at it they decided we weren’t doing anything value added.

‘We went through an exercise in 2008 where we came up with 150 extra services we provided, but we were told none of these were above the core contract.’

National Association of Primary Care (NAPC) chairman Dr Charles Alessi also argued that ‘there are issues around how those calculations have been made’.

He said the evaluation of PMS funding was ‘likely to not be sensitive enough to distinguish between places delivering exceptional value and those that have not’.

NAPC vice chairman Dr Peter Smith added: ‘All the hard work of PMS practices in developing new ways of improving quality is discounted and belittled by referring to the resources received as a "premium", demonstrating at a stroke the disdain for all the efforts expended.’

He argued that ‘most PMS practices’ have KPIs demonstrating the improved quality they offer in return for extra funding, but ‘will have to reduce their quality of service as their "premium" that paid for it is removed’

In a statement released with the PMS review, NHS England director of commissioning policy and primary care Ben Dyson said: 'NHS England is committed to supporting innovation and quality improvement in primary care and reducing health inequalities.

'We want to continue to use PMS arrangements to achieve these objectives. At the same time, we need to ensure that there is an equitable approach to funding. Where GP practices are receiving extra funding per patient, this has to be fairly and transparently linked to the quality of care they provide for patients or the particular needs of the local population that they serve.’

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