Practices face huge losses as PMS review looms

Details of a PMS funding review that could strip millions of pounds from practices will be revealed within weeks by NHS England, GP has learned.

Dr Richard Vautrey: funding from PMS must remain within general practice
Dr Richard Vautrey: funding from PMS must remain within general practice

GPC deputy chairman Dr Richard Vautrey said it was of real concern that NHS England had taken so long to review how it will equalise PMS and GMS funding following last year’s contract imposition.

‘PMS practices don’t have any confidence that the funding they receive will be in place [after April],' he said.

‘They can’t make plans because of fears that NHS England will take significant amounts of their funding away.’

Earlier this year the GPC warned that £200m could be lost from general practice as PMS contracts were levelled down in the equalisation drive.

Dr Vautrey said it would be a ‘disaster for general practice as a whole’ if any funding at all was lost at a time of underinvestment and increasing pressures.

‘We all recognise there needs to be a move towards greater fairness in funding,' Dr Vautrey said. ‘The worst thing, though, would be to level down, rather than utilise existing funding within GMS and PMS practices to ensure all practices benefit from the resources available.’

NHS England announced the PMS national review in June as part of the process of equalising GP contracts. It will determine whether money paid to PMS practices above and beyond GMS funding is effectively core pay or enhanced service funding.

A letter sent to area teams in June said: ‘This review will need to consider how far PMS expenditure (in so far as it exceeds the equivalent expenditure on GMS services) is effectively paying for "core" primary care services and should be treated in the same way as MPIG expenditure.’

The review will also consider ‘how far it is paying for "enhanced" primary care services’.

If NHS England determines that a large proportion of extra cash paid to PMS practices is effectively enhanced services funding, it could be cut or opened up to other providers rather than redistributed among GP practices.

Dr Vautrey said PMS practices faced ‘unacceptable’ losses of ‘thousands and thousands of pounds’ in the worst-case scenario. 

But the GPC has been given no information by NHS England about how much money could be cut.

NHS England’s head of primary care commissioning Dr David Geddes has told GP that part of PMS funding could be handed to CCGs to pay for services that practices would compete for with other providers.

Dr Vautrey called for money taken from PMS contracts to be reinvested in core funding rather than being used to fund additional work.

‘If NHS England rebadged any of that money for lots of extra work, it’s going to lead to even more pressure on practices.’ But he added: ‘I’m sure NHS England will want to take some of that to use for other things. We need to try and limit that as much as possible.’

A spokesman for NHS England said: ‘We expect to announce wider next steps on PMS, following the PMS disaggregation exercise, in about a month’s time.’

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