PMS funding cuts could be unlawful, warns Yorkshire GP

PMS contract cuts that threaten to close practices could be unlawful, according to a GP whose practice faces a 44% reduction in funding.

A partner and patients at a PMS practice in West Yorkshire have accused NHS England of failing to involve patients in a PMS review which could result in a 44% funding cut.

Slaithwaite Health Centre GP Dr Paul Wilding said the review could be ‘unlawful’ if commissioners fail to meet their legal requirement to involve patients in decisions which affect services.

But NHS England’s head of co-commissioning for West Yorkshire said the practice had not yet seen any funding reductions and that services would continue until talks with the practice conclude.

GP funding cuts

Patients have formed the Slawit Health Centre SOS campaign group, which has now begun its own consultation to help local people voice concerns on changes they believe will trigger cuts of around £277,000 a year over three years at the practice.

In a separate move, a patient at the practice has launched a legal action against NHS England over the alleged failure to involve the public.

GPs elsewhere have also expressed concern about NHS England’s lack of patient involvement in the PMS review. Dr Kate Bellingham of Page Hall Medical Centre in Sheffield said her practice faces a 21% funding cut over three years following a PMS review.

‘There has been no official process to gain patient opinion or perspective in the funding cuts that have happened locally,’ said Dr Bellingham. ‘There was no recommendation to ask our patients what their thoughts were.’

NHS England’s head of co-commissioning for Yorkshire and Humber Karen Curran said Page Hall’s funding was now being looked at by the CCG and further engagement with patients could take place once the outcome of that process was known.

Dr Bellingham, however, said that cuts to services or staff were now ‘inevitable’.

Patient involvement

In 2014 NHS England admitted it had breached its legal duties by failing to properly involve patients in decisions to withdraw MPIG funding, after a patient at Jubilee Street Practice in east London took action to secure a judicial review. High Court judge Mr Justice Popplewell found the commissioning body had ‘acted unlawfully by reason of its failure to make arrangements for the involvement of patients in primary care commissioning decisions’ as required by legislation. 

Dr Wilding told GPonline the proposed ‘draconian’ PMS cuts would ‘decimate’ the practice leaving it ‘completely non viable in a relatively short period of time’.

‘One of our patients felt so strongly about having not been engaged or consulted with that they took some legal action and are taking legal proceedings against the NHS England,' he said.

Dr Wilding said he had been in contact with PMS practices in other parts of the country and called on GPs to take action. ‘The time for talking is over, it's time for action now. You're running out of time to oppose what may very well be unlawful cuts,’ he said. ‘The main thing you should be doing is going public and telling the public because nobody else has told them.’

Karen Curran, head of co-commissioning at NHS England Yorkshire and Humber said: ‘The purpose of PMS funding is to ensure there is a fair approach to funding across GP practices. 

‘Any changes will not result in a reduction in overall funding in Sheffield but will ensure the money is spread equally and links to the needs of the local population.

'The funding of Page Hall Surgery in relation to the services it provides to local population is currently being looked at by Sheffield CCG.

‘Once the outcome of the CCG’s work is known further engagement will be needed to ensure patients understand any changes to the way services are delivered.'

Kathryn Hilliam, head of co-commissioning at NHS England West Yorkshire, said: ‘Slaithwaite Health Centre ... is one of the higher funded practices in an area with low levels of deprivation when compared to other practices which have significantly challenging health needs.

‘The practice to date has not suffered any financial loss and all services will continue until discussions with the practice have concluded.

‘NHS England expects to meet with the practice in March to agree a way forward and to ensure patients continue to receive the best patient care.’

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