Single contract means the end of PMS

The White Paper's proposal to move to a single national GP contract confirms the end of PMS and could lead to time-limited, APMS-style contracts, senior GPs warn.

Dr Kingsland: unification of contracts was 'many years off' and commissioning negotiations is the first step (Photograph: Bob Stratton)
Dr Kingsland: unification of contracts was 'many years off' and commissioning negotiations is the first step (Photograph: Bob Stratton)

Amid the radical commissioning reform in England, the White Paper also proposes a 'single national contract and funding model' for GPs contracted directly with the new NHS Commissioning Board.

GPs close to the Conservative party have warned that scrapping PMS contracts will anger GPs and mean support for the new commissioning role is lost.

Dr Paul Charlson, chairman of the Conservative Medical Society, said it would inevitably force PMS GPs to move to less favourable contracts.

Dr David Jenner, GMS/PMS lead at the NHS Alliance, warned the White Paper's commitment to 'removing barriers to new providers' suggested a move to short-term contracts. 'Does this mean continuous competitive tendering, with time-limited contracts?' he said. 'I think if you want continuity of care and ongoing family medicine, contracts have to be permanent.'

However Dr James Kingsland, president of the National Association of Primary Care, said a unification of contracts was 'many years off' and the first steps were to negotiate commissioning duties into existing GP contracts.

'PMS contracts fit a lot of the problems in the system we talk about - things like local variation and inequalities - and I would be surprised if the DoH unpicked all that progress.'

The GPC has made it clear that it would support a single contract but has not yet begun negotiations with the DoH.

The White Paper proposes that practices move towards a weighted capitation model of funding, with incentives to improve access in poor areas.

The document also makes it clear that the new consortia will not commission GP services, with primary care contracts being held by the new NHS Commissioning Board.

Dr Jenner said the plans would make negotiating local enhanced services and new practice clinics difficult.

'It will be frustrating for GPs. There has to be a simple set of rules so practices can provide simple services without having to go out to tender.

'If there is a full competitive tender through this board for every single local service, the bureaucracy and expense will be worse than before.'

 Click here to view health White Paper 2010 news and analysis

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