PMS guidance has been drawn up by London LMCs to give GPs ammunition to protect their contracts against 'value-for-money' raids by PCTs.
PCTs have been systematic and acquisitive in seeking value for money from PMS contractors since the health secretary Patricia Hewitt issued directions on financial provisions within PMS agreements last year.
Any variation to the core agreement should follow a step-by-step procedure with a clear method for rebasing contracts, LMC guidance on changes to PMS agreements warns.
'All PCTs with PMS contractors are increasingly looking at value for money especially in relation to growth funds,' said Dr Tony Stanton, joint chief executive at Londonwide LMCs.
'No London PCT has yet threatened a contract termination, but "they are looking"', he said.
Coventry PCT last month withdrew a threat to terminate PMS contracts if contractors failed to agree to revised deals (GP, 16 February - Coventry PCT withdraws threat to end PMS).
Dr Stanton said that members were concerned that PCTs may try to impose changes.
'London-wide LMCs is not prepared to allow its members to be pressurised into accepting changes to their original contracts,' he added.