PMS funding reforms perpetuate GP practice inequality, warns GPC

Plans to redistribute PMS 'premium' funding will fail to create equity between GP practices across England without an additional injection of cash, the GPC has warned.

Dr Richard Vautrey: PMS funding concerns (Photo: JH Lancy)

GP leaders have welcomed a commitment that £325m in PMS funding identified as over and above GMS income will be reinvested in general practice services.

But plans to redistribute the money only within CCG areas, rather than nationally, means practices in some areas will continue to enjoy greater funding than others, the GPC has warned.

GP leaders said the broad commitment to spend the funding on general practice services could leave the door open to PMS funding being diverted to maintain extended access schemes, rather than to bolster core primary care work.

Premises funding warning

Freedoms for NHS England’s area teams to divert the cash to fund premises could also lead to redistributed cash benefiting only a small minority of practices in each area, the GPC warned.

GPC deputy chairman Dr Richard Vautrey said: ‘We have always said the PMS money should remain in general practice, and we welcome the fact this has now been agreed.’

But he warned the deal would be better for areas with ‘large numbers of PMS practices’ than for those with very few.

‘The whole point of this exercise, with the MPIG and PMS review was to ensure all practices receive the same level of funding per patient,’ said Dr Vautrey. ‘That is clearly now not going to happen unless CCGs and NHS England identify funding to make it happen.’

Entrenching inequality

He said redistributing PMS funds within CCG areas would entrench differential funding levels. ‘There will continue to be inequity,’ he warned.

The update on PMS reviews published by NHS England this week pledged that premium funding would be phased out gradually over a ‘minimum four-year period’, with the first year being 2014/15.

The guidance calls for ‘case-by-case’ reviews to ensure that practices facing the loss of premium funding are not deprived of resources they need to cope with ‘special populations’.

Decisions to redistribute money should be made jointly with CCGs as part of co-commissioning arrangements, the guidance says.

However, any areas where PMS changes have already been agreed will not be subject to the guidance, the document warns.

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