PMS contracts being cut or abolished, warns NAPC

Authors: Caroline White 

Publication date:  04 Aug 2012

Patients are being “seriously failed” by the continuing erosion of personal medical services (PMS) contracts in general practice, the National Association of Primary Care (NAPC) has warned.

The association said that practices are increasingly reporting that PMS budgets are being slashed or that primary care trusts are forcing them to revert to the general medical services (GMS) contract.

This trend flies in the face of the localism agenda that the government promotes and will make it hard for services to respond to local need, says the association, which has held talks with health ministers to discuss its concerns.

Its chairman, Charles Alessi, pointed out that the Health and Social Care Act 2012 emphasises the importance of localism to meet the specific health needs of local populations—a view supported wholeheartedly by the NAPC, he said.

“PMS contracts, as originally conceived, also embody the principle of localism—and the tailoring of healthcare services to reflect the specific needs of local patients,” he added.

Patients in various parts of the country were being, and would be, seriously failed by the insistence on adoption of the GMS national contract, he suggested.

“This is a position that the NAPC considers is a failure of the current healthcare system but one which can be and is remedied by the principle of localism,” he said.

Peter Smith, vice president of the association and a GP in Kingston, London, went on to say that the new legislation and PMS contracts, as originally conceived and implemented, dovetail to deliver the most appropriate services and care to local populations.

“Needs are not uniform . . . and to apply a standard contract and standard service to the entire population is both wasteful of taxpayers’ monies and a failure in the delivery of modern healthcare,” he said.

“An overall erosion of quality is evident in many PMS reviews, as services already assessed as value for money are being cut in the regression towards a mean contract,” he added.

Val Hempsey, an executive member of the association and a managing partner of a practice, admitted that the quality of negotiation and oversight of some of the more recent PMS contracts had not been good.

“But, as we move forward, it will be important to ensure that the principle of localism—that is, local services locally determined by patients and clinicians together—is the cornerstone of any future contracts which the government introduces,” she emphasised.

“It is also important that practices fully understand this concept to ensure that local contracts are not debased and therefore devalued by those with responsibility for their monitoring.”

Caroline White BMJ

Cite this as BMJ Careers ; doi: