PMS reviews could devastate GP care in deprived communities, MP warns

PMS contract reviews could 'devastate' front-line GP care in some of England's most deprived communities, an MP has warned.

Karin Smyth MP (Labour, Bristol South) has called on commissioners to reconsider the redistribution of PMS premium funds after practices in her constituency said they faced cuts to services and longer waiting times for patients.

Ms Smyth, a former CCG manager, called on commissioners to redistribute £2m of withdrawn premium funding back to losing PMS practices.

Six PMS practices in the south of Bristol said in a joint statement that redistribution of PMS funding, in line with national NHS England equitable funding policy, would fail to recognise the additional needs of deprived populations.

Five of the six PMS practices are set lose up to £500,000 in funding from next April when redistribution begins.

NHS England identified in 2014 £325m of 'premium' funding that PMS practices receive above GMS equivalent, including £258m which 'may be associated with enhanced services or populations with special needs, but is not defined'.

GP contract reviews

After the redistribution of MPIG top-ups the funding 'premium' received by PMS practices will drop to £235m.

Local commissioners have until March 2016 to conclude reviews of local PMS contracts and decide how far to redeploy any premium funding. Reinvestment must take place over a minimum four-year period from 2015/16.

Bristol’s primary care joint committee is set to agree plans for reinvestment on 19 November. CCGs have until the end of November to publish their commissioning intentions.

Over the summer the GPC warned that PMS practices faced ‘collapse’ because of the withdrawal of premium funds.

Ms Smyth said: ‘Local, accessible GP surgeries that deliver high quality healthcare form a key part of any community, but patients living in some of our city’s poorest areas would find it harder than ever to register with a GP or to get an appointment to see one.

‘While others elsewhere may gain from this redistribution, it is not right to rob Peter to pay Paul.’

GP funding

‘There is still time for the CCG to act wisely. With a decision due this month on the way the £2 million will be used, they can ‘redistribute’ it straight back to these areas that would otherwise lose out. This would protect these surgeries from the loss of funding that they’ve previously received  because of high deprivation levels in communities they serve.’

NHS England south west director of commissioning Linda Prosser said: ‘This is a national review of general practice funding across the country. In Bristol general practices are currently being paid different amounts of money for doing similar things, based on historic agreements that don’t necessarily reflect current patient needs – which isn’t fair to them or patients.  It is important to undertake periodic reviews of these arrangements.

‘Any reductions or increases to GP funding will be made over the next five years to give practices plenty of time to adjust.’

Bristol CCG chairman Dr Martin Jones added: 'A decision on reinvestment funding has not yet been made but is expected to be made by the end of November. We are however already clear that all money will be reinvested back into general practice services.

'Some practices that have benefitted from very high premiums in the past will be likely to lose income from the review process but, overall the majority of practices in Bristol will gain from this process.'

Last week commissioners in east Cheshire agreed £2m of new funding to add to redistributed PMS monney and existing LES funds for a comprehensive, single price per patient offer for practice to provide non-core services. PMS practices set to lose from redistribution would be guaranteed transition funding under the plan which is still being discussed with GPs.

Bristol CCG is preparing a response.

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