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How PMS practices will be affected financially by the NHS England review

NHS England announced on Monday that local areas teams should begin a review of all the PMS contracts under their supervision, and that review must be completed by 31 March 2016.

The purpose of the review is to ensure that at the end of it, there is equity of funding across all practices whether GMS, PMS or APMS, and that they all receive the same funding for core services.

This will be achieved by identifying the ‘premium’ element in the PMS contract and removing this from the core funding and redeploying it through PMS or other routes. The redeployment need to achieve the following:

  •  reflect joint plans for primary care
  •  provide services outside the scope of core activities
  •  help reduce health inequalities
  • equally support all practices
  • distribute resources fairly at a local level

The pace of change has to take into account the services to patients and the practice, but NHS England does state that if a consequence of the review is that the PMS contract does not reflect value for money, it can be terminated.

A comparison between GMS and PMS shows that PMS practices currently receive a premium of £13.52 per patient. As GMS practices receive a larger global sum in lieu of their MPIG, so the discrepancy in their core funding reduces and by the time the MPIG has gone, the discrepancy will have reduced to £9.80.

The average practice has around 2,700 patients per partner, so in crude terms, the average PMS partner will lose £26,460 however, some resources will be put into other services that the GP can apply for.

The real concern will be the implementation for practices that have had higher than average funding in the past for reasons that were acceptable at the time. If the criteria has changed, then the loss could be dramatic and would necessitate a review of the way the practice used it’s resources.

The key points to bear in mind is that a practice can only use the resources that they are allocated, and can only use them once, and they have to leave the partners with a reasonable profit.

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