CCGs ‘are merging practices to remove APMS contracts’

Some CCGs across the country are actively merging practices that are under the APMS contract with those that are under GMS or PMS contracts in order to remove APMS from the system, the BMA has claimed.
 
CCGs are doing this because AMPS contracts are too difficult to manage and ‘don’t deliver better quality of care’, according to BMA GP Committee chair Dr Richard Vautrey.
 
This news comes despite NHS England previously saying that all new contracts should be APMS.
 
APMS – Alternative Provider Medical Services – contracts were first introduced in 2004 to open up primary care to ‘new providers’ and were famously used to procure the Labour government’s ill-fated ‘Darzi’ centres across the country. 
 
Unlike GMS contracts, they are awarded with a time limit, rather than perpetuity, and they can be held by companies as well as GP partners.
 
In 2014, Pulse revealed that all new GP contracts would be time-limited APMS contracts instead of GMS or PMS, with NHS England saying that ‘APMS effectively does the same job and does not come with the same risks’ as GMS contracts, and so all new GP practices should ‘be on APMS’.
 
But GPC chair Dr Richard Vautrey told Pulse that CCGs are now switching practices from AMPS to GMS, through mergers.
 
He said: ‘What I know they have done, is look for existing PMS/GMS practices in the area and invited them to come forward and effectively merge their contracts. So it reduces the number of practices, but it reduces it in a favourable way, but removing AMPS out of the system.’
 
Dr Vautrey continued: ‘There are a number of CCGs that are doing this, where they see the difficulty of contract managing an APMS contract and all that goes with that, is really not worth the hassle that they have, and they don’t deliver better quality of care, they are not delivering in the way that maybe people thought they would.
 
‘They are finding it much better to bring practices into a GMS or PMS arrangement, give them some certainty and make sure they are aligned with other practices in the area.’
 
Pulse previously revealed an increasing trend towards APMS contracts, with NHS competition watchdog Monitor investigating how to make it easier for alternative ‘high quality’ providers to set up GP practices in areas of low quality care, despite warnings from the GPC not to put ‘competition ahead of continuity’.
 
NHS England and NHS Clinical Commissioners both declined to comment. 
 
This story was first published on our sister publication Pulse.