PMS GPs need a clear direction for the future

It is estimated that 40 per cent of practices in England hold PMS contracts but it may be a surprise to learn that 'PMS' doesn't merit one mention in the Health and Social Care Bill, currently in the committee stage in the Commons.

What is clear, however, is the coalition government's drive for a single, unified GP contract.

This week's GP newspaper reveals that Dr James Kingsland, the DoH's national clinical commissioning network lead for England, believes that the moves to merge all contracts, GMS, PMS and APMS, into one will take a minimum of five years.

But what happens in the meantime to PMS GPs who have in recent years faced annual assaults on their budgets from PCTs under ever increasing cash pressures of their own?

Indeed, what will happen to them as PCTs disband and the National Commissioning Board starts to hold primary care contracts? How can PMS contracts, which by their very nature depend on local negotiation over additional services required in a particular area, retain the same feel when they are being debated by a body based centrally?

Also, how happy will consortia be to accept PMS practices into the fold when so many question marks hang over their future funding and the cashflow of practices within each consortium are so inextricably linked? How do you convert a PMS contract into a GMS equivalent? Accountants are talking about the possibility of PMS deals across regions. Others are going as far as to speculate that the National Commissioning Board might have a 'regional presence'.

If this is all starting to sound a little like the reinvention of SHAs to appease those complaining that the abolition of NHS management structures is happening too fast, then at least it will be of some comfort to PMS GPs.

What PMS practices, and GMS counterparts contemplating inviting PMS GPs to join consortia for that matter, need is greater clarity over their future as the coalition government pursues its NHS 'evolution'.

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