NHS England criticised over speed of premium payment cutback plan

The body’s West Yorkshire area team last week wrote to GP practices on personal medical services contracts - which are agreed locally - announcing that each practice’s payments will be reviewed before April next year.

HSJ understands that the reviews aim to identify how much extra PMS practices are being paid compared with those on general medical services contracts – which are agreed nationally - for doing similar work.

The letter states that  the “PMS premium” for each practice in the region would be reduced year on year from April 2015 onwards with the main cuts carried out between 2015 and 2018.

After these three years of cuts,  some practices could see payments increases as part of a levelling out exercise that will check whether their income had fallen too far.

Charles Alessi, chair of the National Association of Primary Care, which represents many PMS practices, accused commissioners of “discriminating” against them.

PMS practices were being handed “worse terms and conditions” than their GMS counterparts whose payments are being levelled out over a seven year period.

 “Unless NHS England is careful, PMS won’t be able to continue as a contractual form,” he warned.

Richard Vautrey, deputy chair of the BMA’s GP committee, expressed concern that funding taken from practices would not necessarily be reinvested back into general practice.

Dr Vautrey, who is a practicing GP in Leeds, said there was a “real risk.. some of this funding will be used to fund deficits [in other parts of the NHS]”.

“That’s a real concern because it is vital resource that funds basic general practice, and is at risk of being lost,” he continued.

He said the funding reductions would “undoubtedly” lead to practice closures.

“There will be quite a number of PMS practices who were viable with the resource that they’ve got, and will become unviable with the cuts that are likely to happen.”

Plans to cut PMS premiums are being put in place across the country after an NHS England review discovered PMS practices received  £325m more than those with GMS contracts.

Around 45 per cent of practices across England are on PMS contracts.

Following the review, NHS England’s areas teams were instructed to examine all PMS contracts in their areas by April 2016.

This exercise aimed to pinpoint which extra payments were justifiable and how quickly adjustments could be made to practices’ incomes.

Although no national deadline has been set, NHS England has said that changes to core GMS payments due over the next seven years would result in a £235m reduction in the national PMS premium.