GPs have cautiously welcomed official guidance that appears to ensure “premium payments” clawed back from GP practices can only be spent on primary care services.
The directives were circulated last month by NHS England to its regional area teams.
These area teams have this year been instructed to review all contracts for GP practices using personal medical services, which are negotiated locally.
An NHS review found that these practices received £325m more than those with nationally agreed general medical services contracts.
The guidance appears to address concerns that premium payments clawed back by NHS England would be used to help plug financial holes in other parts of the healthcare system.
It said that any “PMS premiums” taken from practices in their areas must be reinvested in general practice services and redistributed over a minimum of four years from 2014-15”.
- NHS England changes will ‘give CCGs freedom’
- Large majority of CCGs gearing up for GP contract responsibility
- All practices to publish earnings under new GP contract
PMS premiums recovered by the areas teams must also be redeployed within practices’ clinical commissioning group area, unless all CCGs decide otherwise.
Peter Smith, vice-chair of the National Association of Primary Care, said the framework brought “some assurances”.
Richard Vautrey, deputy chair of the British Medial Association’s GP committee, said it gave “some clarity for both practices and CCGs which has been long overdue”.
However, he added: “The bigger question now is how the resources that have been freed up will be used by CCGs: whether they will be used for funding core service or elements of core services for all practices within an area, or whether there will be an expectation that practices will have to do significantly more work to get that money back again to support their ongoing activities.”
Dr Vautrey also warned: “There will be concerns raised by those CCGs that don’t have very many PMS practices… about the embedding of historic inequalities.”
He urged CCGs to use the “flexibility within their own allocations” to “try and identify additional resource that can be used to [level up funding] for their member practices, compared with the neighbouring CCG that might use their PMS freed up resource”.
“A failure to do so would put at a disadvantage those practices in a CCG area that don’t have large numbers of PMS practices,” he said.