PCTs try to replace GP contracts with enhanced service packages

GPs in England are facing attempts to replace GMS, PMS and APMS contracts with 'enhanced service packages' as PCTs try to standardise the services practices provide.

Dr Buckman: If PCTs attempt to alter GMS contracts it would be illegal
Dr Buckman: If PCTs attempt to alter GMS contracts it would be illegal

NHS Liverpool is developing the ‘Liverpool Enhanced Service’ to replace the GMS, PMS, PCTMS and APMS contracts held with practices in the area.

Practices will receive a flat fee to replace the variable funding that practices receive through different contracts and local and directed enhanced services.

If GMS practices refuse to switch to the new contract, they will not be commissioned to provide local enhanced services, PEC board papers reveal. Practices will also be required to perform 70 appointments per 1000 patients rather than 50.

Although the PCT claims practices’ funding will increase by £5.6m, the new service ‘specification’ will see GPs take on up to £12m of work from secondary care.

NHS Derbyshire County is proposing a similar scheme, where all practices will receive funding ‘at GMS global sum value’ plus a £11 per patient for a package of nine enhanced services.

Rob Barnett, Liverpool LMC secretary, said local GPs were involved in the discussions but 'a lot will depend on how the PCT decides to measure success.'

'The proposal is an attempt to bring funding and services to a less uneven level,' he said.

'It is based upon the astonishing fact that general practice in Liverpool is one of the lowest funded in the country and the PCT handed a surplus back to the SHA this year. There has been no agreement yet and a lot depends on the PCT in terms of what it expects from practices.

Dr Barnet said some practices would benefit from the increase in funding but others simply would not have the space to employ more staff and provide certain clinics.

'I am as concerned as many others are. If the PCT thinks it will tie up practices in knots with this it will get very few practices on board.'

GPC chairman Dr Laurence Buckman said the proposals were 'not new contracts' and said it was up to PCTs to decide how they offer enhanced services. But if PCTs attempt to alter GMS contracts it would be illegal, he said. 

Standardising the funding GPs receive across a PCT, as long as a reasonable amount is provided, could be less bureaucratic, he said.

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