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of primary care
National Association of Primary Care (NAPC)
PMS In 2012
20 July 2012
NAPC has recently been in discussions with ministers at the Department of Health, following major concerns raised by practices across the country. NAPC has received a substantial number of reports, with ever increasing frequency, about the arbitrary slashing of Personal Medical Services’ (PMS) budgets or indeed PCTs’ insistence upon practices reverting to a General Medical Services (GMS) contract. In the light of these worrying developments, NAPC has made its position clear to ministers.
Dr Charles Alessi, Chairman of NAPC, commented: ‘The most recent legislation, the Health and Social Care Act, which embodies the details of the reform agenda, majors on the importance of localism to reflect and address the specific health needs of local populations; a view supported wholeheartedly by NAPC.
‘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. Patient groups are not homogenous and one contract does not fit all requirements. Moreover, there are patients in various parts of the country who would be and are being seriously failed by the insistence upon the adoption of the GMS national contract. This is a position, which NAPC considers is a failure of the current healthcare system, but one which can be and is remedied by the principle of localism.’
Dr Peter Smith, Vice-President of NAPC and a GP in Kingston, went on to say: ‘The Health and Social Care Act and PMS contracts, as originally conceived and implemented, dovetail to deliver the most appropriate services and care to local populations. This is both a sensible use of resources and the most appropriate way to deliver improved healthcare outcomes. In the 21st century, we cannot continue to deliver care by rote. Equity does not equal equality. Needs are not uniform, ability of practices to deliver targeted services differs, 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. 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.’
‘Of course, there have been administrative failures in the negotiating and oversight of some of the later PMS contracts, which have done little to address local needs’, Val Hempsey, an Executive member of NAPC and a managing partner of a practice, commented. ‘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. 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.’
Dr James Kingsland, President of NAPC, GP in Wirral and Department of Health Clinical Lead for PMS Development 1999-2002, continued: ‘Localism is the future for the modernisation of the NHS and for the implementation of the finest healthcare globally. It is critical to their success. It is the only way in which patients can be placed firmly at the centre of all healthcare they receive - another of the cornerstones of the Health and Social Care Act. In future negotiations of primary care contracts, healthcare will fail, without the acceptance and embrace of this principle.’
Notes to editors:
1. The National Association of Primary Care (NAPC) is a non-political, non-profit-making organisation representing and supporting the interests of all its members, both individuals and organisations working in or with primary care. It also offers support through associate membership to those bodies, which provide services to primary care or have other health-related interests. Find out more at www.napc.co.uk
2. For further comment contact:
Dr Pete Smith on 0787 9696960 or