Personal medical services agreements
Section 5 - Movement to GMS
Before 1 April 2004, individual doctors had a right of return to PMS. Under the PMS Agreements Regulations, this right now applies to contractors, rather than individual doctors. Return to GMS is therefore now a practice decision (see part 6, Regulation 19).
The contractor must notify the PCO that it wants to enter into a GMS contract three months before the date on which it wants the GMS contract to take effect. The notice to the PCO must specify the date on which the contractor wants to terminate the PMS agreement, the names of the persons with whom the contractor wishes the PCO to enter into a GMS contract and to confirm that those persons meet the relevant conditions (as set out in Regulations 4 and 5 of the GMS Contracts Regulations).
There is no agreed formal mechanism for determining the financial position of PMS practices who wish to enter into a GMS contract. Whilst these practices have no statutory right to a Minimum Practice Income Guarantee (the income protection guarantee that GMS practices had on transfer from the old to new GMS contract), John Hutton’s October 2003 letter to PMS GPs stated
“A PMS pilot practice could make a strong and robust case for having an MPIG from 1 April in discussion with the PCT. The practice would be expected to provide the data which could be assessed by the PCT using:
- the local data on payments for Global Sum Equivalent items that they may have available for the pilot; this might include some or all of growth monies relating to contract variations forming part of the practice’s Global Sum Equivalent
- a national average calculation (if the supporting data are not robust enough to do the calculation) based on PMS earnings and GSE”.
There is no automatic entitlement to retain growth monies on movement to PMS. However, the Hutton letter stressed that this should be allowed “where a practice provides evidence that some growth should form part of the GSE”. If the growth money is retained, the PCO may use it for the benefit of patients across GMS and PMS practices.
There is some further guidance on this in section 6.12 of Sustaining Innovation Through New PMS Arrangements. However, at the time of writing no more detailed guidance had been produced.