Personal medical services agreements
Section 1 - Permanence
Until 1 April 2004, PMS agreements were “pilot” agreements. This meant that they were experimental and could not necessarily be considered permanent arrangements. However, the pilot phase of PMS is now over and, from 1 April, all existing PMS agreements have become permanent. The introduction of PMS agreements by way of centrally-coordinated, twice-yearly “waves” is over. As a contractual option, it is now on an equal footing with GMS and practices and PCOs can negotiate and sign PMS agreements at any time without needing to apply to the Secretary of State.
This fundamental change in the status of PMS agreements was set out in a letter from John Hutton to PMS GPs dated 15 October 2003. The letter stressed that making PMS permanent and transferring elements of the new GMS contract to PMS, should not lead to existing PMS agreements being “unpicked”. Although the meaning of “unpicked” is ambiguous, the general intention is that the national changes to PMS policy should not disrupt local PMS agreements, or cause them to be re-written from scratch.
New PMS regulations came into force on 1 April 2004 and made permanence official. These are the National Health Service (Personal Medical Services) Agreements 2004 Regulations and they can be found on the HMSO website (www.hmso.gov.uk). Section 4 of this guidance covers some of the most important aspects of the new regulations, which introduce to PMS much of the regulatory regime of new GMS.
Most financial aspects of PMS remain ungoverned by statutory instruments. This is in marked contrast to new GMS, which is underpinned by a national, guaranteed system of payment laid down in the Statement of Financial Entitlements (SFE). So despite the broad equivalence of GMS and PMS in certain areas of law and policy, PMS remains a genuinely local agreement as far as practice level finance is concerned. Practices should only enter a PMS agreement if they are confident with this fact and fully aware of its implications, which are laid out in more detail in this guidance note.