New details reveal the extent of funding fluctuations for APMS practices as commissioners across England have implemented equitable funding on reprocured contracts.
GP leaders warned that the instability created by short-term APMS contracts were a sign of an obsession with competition in the NHS that was letting patients down.
GPonline obtained details of 70 time limited, locally commissioned APMS contract terminations and reprocurements initiated in the first six months of 2014/15 from all NHS England areas outside of London.
Of the 70 contracts detailed, 22 were extended without variation, seven extended with variations, seven were terminated and 32 were reprocured.
Thirteen of the 21 completed reprocurements - around 62% - faced funding changes. One of the contracts varied by commissioners also had its funding changed.
The number of practices facing funding cuts was around double the number which had their funding increased.
Equitable funding policy
Most of the reprocured APMS contracts had their global sum equivalents (GSE) aligned with GMS funding, in line with the government's equitable funding policy. That requirement, announced by the government in 2012, has seen funding losses for MPIG-dependent GMS practices and cuts in premium payments to PMS contractors.
The new details revealed the extent to which APMS practices are also being affected. Reprocured contracts may also have new KPIs inserted, also affecting practice funding.
Losses ranged from £12.59 to £46.44 per patient. The biggest loser, a practice in Newcastle, faced annual losses of almost £340,000.
Meanwhile the biggest gain, for a practice in Wirral, was a £91.80 per patient increase - an annual funding rise of over £276,000 - including aligning the GSE with GMS and a top-up payment for new KPIs.
GPC deputy chairman Dr Richard Vautrey: ‘Many practices now with APMS contracts were formerly run by PCTs through PCT-MS contract arrangements and the funding provided was often not comparable to other local GMS or PMS practices.
'As short-term contracts have to be repeatedly re-commissioned, creating instability for practices and patients, and incurring significant costs in NHS management time, it would have been far better to support the development of much more stable GMS or PMS practices in the first place.
'It's yet another sign of how the obsession with competition within the NHS has and is letting patients down and probably costing more in the long-run.’