PMS Reviews - next steps

On Monday 26th January, LLR LMC attended a meeting of the task and finish group where we outlined the following principles:

1. The communication sent by NHS England on 30th December has caused considerable distress to many individuals working in PMS practices – the tight timescale and deadlines for responses to a communication and calculator that had errors and ambiguities has had a detrimental impact on morale and relationships;
2. A variation to a practices individual contract is an enormous decision, which requires the partners in each practice to have reasonable time for careful consideration and to have an opportunity to seek legal and financial advice;
3. The NHS England guidance on the PMS Review process acknowledged that practices would need clarity about the funding that will be available to replace part or all of lost funding; 
4. Representatives of individual practices must be offered an opportunity to have individual meetings with the commissioning organisation to seek clarification on the implications of the proposals for variation of their contract; 
5. PMS contract holders have a contractual right to open negotiation to vary their contracts;
6. Practices feel under pressure to make a decision with a time limited offer for loss of funding over 6 years - which will be withdrawn and revert to reduction over a much shorter timescale;
7. With any contract renegotiation all parties need to behave reasonably - a very short timescale to express interest in a limited range of options with a lack of clarity about how long a less punitive option will be available is not reasonable;
8. There was never any intention for the variation clause in PMS Contracts to be fettered by a termination clause. The threat of termination of contract without cause with six months’ notice asserts a serious and unreasonable pressure on practices.

The next step is to give partners and practice managers in individual practices time to consider the implications of the options being proposed to vary their contracts and to ‘claw back’ PMS premiums which were initially part of the additional funding within a PMS contract for additional services and/or to address anticipated list growth.