Exclusive: GPs face fight for PMS cash

GPs face competition with other providers to earn back up to £200m in funding likely to be cut from PMS budgets.

Funding cut from practices in the national PMS review could be handed to CCGs to commission additional primary care services, according to a senior NHS England official.

Speaking exclusively to GP, NHS England head of primary care commissioning Dr David Geddes said part of the funding could be redistributed across all practices' core funding, as demanded by GP leaders.

But the rest could be handed to CCGs under plans expected to be finalised within months, Dr Geddes revealed.

Funding handed to CCGs would pay for services that GPs would have to compete with other providers to secure.

GPC deputy chairman Dr Richard Vautrey said practices feared a 'massive' funding cut.
As much as £200m is expected to be stripped from PMS practices in the ongoing NHS England review, launched in June.

GP leaders have warned the loss of this amount of funding from general practice could have a 'catastrophic' impact.

Dr Geddes said initial research into all PMS practices' contracts was near completion at the end of August, and the full analysis would be completed in September and October.

'We are assessing what in the PMS contract would naturally sit in the GMS core contract, so we don't inadvertently compare PMS practices differently from GMS,' he said.

'Once we have that detail we will be able to understand what the differences in funding are. One of the principles NHS England is adhering to is that we should be expecting funding per patient to be equitable never mind whether you are a GMS or PMS practice.'

Additional funding identified in the review as linked to provision of core services is likely to be treated in the same way as MPIG funding, and redistributed across all practices.

But NHS leaders want to cut extra money in PMS practices' baseline funding for anything deemed to be effectively an enhanced service.

It is this element of PMS funding that could be handed to CCGs.

Dr Geddes said PMS practices had been developed to be 'creative' in service delivery, but now that should be directed by CCGs, freed from restrictions created by differences in GP contracts.

'We have to let CCGs have that opportunity to have some funding to play with,' he said.
He added: 'Some of it is about increasing global sum, because I think that gives us more capacity within the system to be able to fund core GMS service. Otherwise we need to  ensure we maintain the capacity to work with CCGs to do things differently.'

Dr Richard Vautrey said all practices were 'very anxious' about the review and 'fearful the result could be an unjustified massive cut in their funding with money diverted to funding deficits elsewhere in the NHS budget'. That would be a 'disaster for patients', he said.

'Unfortunately because the DH imposed this on the profession, we are not in a position to be able to reassure practices about the outcome, and yet there are only a few months until these changes could take place.'

He added: 'It is in the long-term interests of PMS practices as well as GMS practices that the woefully low level of global sum is increased so that practices have the necessary funding to be able to do what patients expect GPs to do - treat those who are ill and who believe themselves to be ill.'

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