PMS practices face heavy losses under 'equitable funding' plans

Many PMS practices could lose tens of thousands of pounds and be forced to switch back to GMS under plans to standardise GP funding, despite NHS officials pledging that the local contracts have a future.

DH: PMS and GMS practices to receive equal funding
DH: PMS and GMS practices to receive equal funding

PMS practices will be brought to the same level of core funding as GMS practices over a seven-year period from 2014, NHS Commissioning Board (NHSCB) head of primary care Dr David Geddes told a conference in London on Wednesday.

The funding shift will be imposed in tandem with the axeing of MPIG top-ups to GMS practices' core pay from 2014. Because PMS practices currently receive higher funding on average than their GMS counterparts, the move will trigger major losses for many, accountants warned.

Dr Geddes told the National Association of Primary Care event that the NHSCB had no intention of getting rid of the PMS contract, but that the move to core funding could present an opportunity for some to revert to GMS.

‘We’re not going to rush into this, it’s about developing an equitable approach to core funding,' he said. 'We want to apply that to PMS and GMS practices but it does not mean the end of PMS contracts.

‘It is however an opportunity for PMS practices to decide whether they want to revert to a GMS contract. The NHSCB is not in a game where we wish you to choose one over the other.’

Mark Wilson, director of Silverthorne consulting, told the conference that some PMS practices may be better off reverting to GMS.

‘A word of caution, if they don’t do the work properly and pile all of PMS expenditure in [to the core funding] I advise you now as soon as that target price is announced move straight to GMS.’

Mr Wilson said PMS practices would benefit by reverting to GMS because they would receive payment on top of their core funding for things such as seniority payments, currently included in PMS core funding.

Speaking to GP, Russell Finn, of specialist medical accountants Ramsay Brown & Partners, warned that some high-earning PMS practices could lose ‘tens of thousands’ of pounds if they were moved to the same level of core funding as GMS practices.

‘The funding announced will be pretty disastrous for most GMS practices with an MPIG so I can’t imagine that it will be much better for PMS practices when their average funding per patient is higher,’ he said.

Dr Geddes said it was the intention of the NHSCB to put back into general practice any extra funds that were removed from PMS contracts as a result of the move to equitable funding. However the money would not be directly transferred into core funding but would be used to fund extra work, Dr Geddes said.

‘You don’t want just to have money coming out from PMS and saying: "That’s now to be spread across everyone for no gain for that." It's money that is in the system so we want to pay them into the system in a way that you get something valuable out.’

DH head of primary care Richard Armstrong admitted it would be extremely difficult to calculate how much the core equitable funding for GMS and PMS would be worth by the end of the seven-year period, because currently funding levels were almost impossible to compare.

When asked when a ‘target figure’ for core funding for PMS and GMS was likely to be calculated, Mr Armstrong said he thought it would be available ‘the other side of this summer holiday’.

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