1      Numbers of GPs in PMS

The LMC has requested Lockharts solicitors to update our PMS contract for wave 5. This needs inclusion of new regulations with regard to out-of-hours arrangements, also the requirement for PMS GPs to participate in appraisal.

Once the LMC wave 5 version is available, we will email this to all 5^th wave practices.Please note that this contract is for the exclusive use of GPs in Beds & Herts and should not be modified or transmitted elsewhere in the health service.

Following the Carson Review of out-of-hours services, regulations have been introduced for GMS to ensure that out-of-hours providers (co-ops and deputising services) are accredited so that GPs can transfer their responsibility for out-of-hours services to them.

This new system of accrediting out-of-hours providers and allowing transfer of out-of-hours responsibility to accredited providers has now been extended to PMS via the NHS (Out-of-Hours Provision of PMS and Miscellaneous Amendments) Regulations 2002.

This means that you can transfer your obligations outside normal hours to an accredited out-of-hours service provider through an out-of-hours agreement, subject to the approval of the PCT with whom your PMS agreement is held.

Please note that PCTs will be able to withdraw approval of an out-of-hours provider, eg a co-op (with immediate effect if necessary) where the approving body is satisfied that this course of action is in the best interests of the pilot scheme’s patients.

Suspension (or withdrawal) of services is via the issuing of a ‘remedial notice’ which sets out the grounds for concern with the quality of service to patients and what remedial action is needed for approval to be reinstated.

PCTs cannot issue such a remedial notice without consulting the LMC.

Please note these arrangements for out-of-hours for both GMS and PMS practices do not go as far as the next stage of completely ‘opting out’ of out-of-hours service provision which has been proposed in the GMS new contract regulations. If this comes into being, separate regulations will be needed to allow PMS practices to also ‘opt out’ from out-of-hours provision which then becomes totally the responsibility of the PCT.

This is summarised from Dr John Chisholm’s speech to a special meeting for LMCs on 10 January 2003.

	Keep practice options open
	Practices tempted into PMS by current short term gain have the possibility of going back to GMS if deemed more advantageous in the longer term.
	PMS still lacks the security of national negotiations
	PMS funding by PCTs is in their ‘part 1’ funding and under PCT direction.
	The ability to ‘opt out’ of OUT-OF-HOURS will be extended to PMS
	The method of allocation of PMS resources will change to the new GMS arrangements
	PMS practices in the future will also be judged on a quality and outcomes framework
	Practices must do what is right for themselves in deciding on PMS/GMS.
	For the ballot, ‘all GPs should also vote in the long term interest of general practice’.
	All GPs (GMS, PMS, non-principals and registrars) will have a vote, and the opportunity to work the new contract if agreed.

 

Dr Judy Gilley

January 2003