Media Archive 2006

In responding to the Secretary of State’s announcement yesterday that the unaudited NHS accounts for the financial year 2005/6, which excluded foundation trusts, revealed a deficit of a reported £512m, Dr James Kingsland, Chairman of the National Association of Primary Care, commented that the scale of the debt was such that it was unrealistic to expect Primary Care Trusts (PCTs) to be in financial balance at the end of the financial year 2006/7, who, simultaneously, are in the midst of a very major restructuring programme.

Dr Kingsland continued: ‘NAPC’s members are very clear that the way in which the NHS will thrive in the future is through the policy of Practice Based Commissioning (PBC), whereby primary care commissioners and providers manage demand and redesign services, with their local populations. Without PBC, PCTs will struggle to manage deficits in a downward direction without affecting patient care and health, as well as risking other government health policies.  PCTs’ proactive engagement of local practices through PBC will both systematically enable the NHS to be reformed and the scale of the debt reduced.  Such action requires true partnership and trust. This is not a time for prevarication, but for unity and determination to ensure that the investment in the NHS yields benefits for the population of this country’.

In the above guidance on non-GMS contracting arrangements for 2006/7, PCTs and SHAs have been asked to introduce efficiencies into local Personal Medical Services (PMS) contracts in order to deliver the equivalent net effect due in 2006/7 from General Medical Services (GMS) contracts.

In commenting on the guidance, Dr James Kingsland, Chairman of NAPC, stated: ‘In seeking to secure such efficiencies in local PMS contracts, both practices, as well as PCTs and SHAs are reminded that as a result of the mainstreaming of PMS contracts in 2004?, the Government made a commitment not to unpick existing financial arrangements, except where local PMS contractors have agreed to such an approach, and only in those circumstances’.

Dr Kingsland continued: ‘PMS practices are encouraged to contact NAPC, where there are any proposals on the part of PCTs or SHAs to breach either the intention or the spirit of the guidance.  NAPC runs a helpline to support its members and will bring evidence of any such breaches in the application of the guidance to the attention of Lord Warner, who was responsible for issuing the joint press statement issued last week’.

Contact details for the helpline are: 020 7636 1677 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it

***ENDS***

“PCTs will be working with practices and LMCs to discuss and agree contracts for next year. In doing so, they will be looking to secure similar changes to those outlined in GMS. This means an approach based on:

Delivering improved efficiency - through freezing current contract prices, making continuous improvements in quality delivery secured through the national QOF, as well as new arrangements for dispensing doctors. We look to PCTs and practices to work together to introduce these changes in local contracts. Together these measures will secure real improvements for patients as practices continue to respond innovatively to deliver better care to their patients.

Continued investment in practices through Directed Enhanced Services that increase patient access & choice, drive greater utilisations and uptake of information & IT systems and incentivise the roll out of Practice Based Commissioning.

The final balance between actual levels of efficiency and new investment will vary between practices depending on local contract discussions, particularly where practices concerned are dispensing practices.

PCTs are reminded that existing contractual provision is based on an agreement jointly entered into, and that changes to those arrangements may only be achieved through proper consultation and negotiation with practices.  . That means where additional efficiencies over and above that currently expected can only be achieved with the agreement of the practices concerned.

The Government and NAPC remain committed to the benefits that can jointly be achieved for patients, practices and the NHS from high quality, appropriate local contracting that allows innovation in service delivery.  However, securing value for money, as well as high quality care and a greater range of services delivered in a local setting remains a pre-requisite to achieving a sustainable partnership between contractors and commissioners.

**ENDS**

Contact details for NAPC Executive Members are as follows:

Dr James Kingsland:  07887 894 124

Dr Peter Smith:  07879 696 960

Dr Johnny Marshall: 07802 946 196

Dr Howard Freeman: 0207 636 7228