Contract Review: Millions taken out of PMS practices?

Recently published by Old Geezer on the FPM Blog, this article wonders whether PMS practices should worry about the latest round of budget reductions. And with all due respect to the fair amount of optimism that strives to survive within each and every one of us, the answer could be yes. Here is why.

The idea that the PMS growth moneys may be regarded as enhanced services funding rather than core contract funding is a convenient way for the government to justify the cuts – it’s surely time for practices to decide which of the “enhanced services” they will cut out when this happens, and do it, rather than just postulating. Many practices paid for Nurse Practitioners or additional GPs with this money – if it goes then it must be assumed that the services these people provide will also be dumped.

It’s time to stand up and be counted. Instead of tweaking the old contracts constantly so that nobody other than the bean counters understand what the hell is going on (the more obscure financial calculations are beyond most none-geeks out there) it is probably time to bite the bullet and draft a whole new contract with a whole new, fresh funding package. It might be painful, and there will be tears, but how long can we bumble along with a contract which is grossly out of date, does not cover the issues that GP practices want it to, and where it still refers to hospital terms and conditions of service, and the Whitley Scale?

The ability to charge a fee to patients for a private service where the NHS has decided not to commission it locally, for example, would be a financial lifeline for many practices with no dosh. Why can one of my GPs (for example) not stick a needle in an arm for £10 when a non-qualifying patient asks for a flu jab, or whip off a pimple for a fee using his hot cattle-prod. Even now he could send them to the practice down the road and they can do it, so what’s the issue? The practice want it, and the patients want it.

If the NHS won’t do it, it should be open season. How that differs to dentists charging NHS patients escapes me? They always seem to squeeze at least sixteen quid out of me – who would challenge a fee with someone about to drill your teeth? I bet their volume of complaints is low.

Perhaps that’s what the GP negotiators need – teeth.

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