1. 2004-05 Primary Medical Services Allocation Personal Medical Services

2. 2004-05 PMS Allocations PMS forms part of Primary Medical Services Allocations to PCTs, as notified on 6 February 2004. Broad principles of how PMS works will remain the same - schemes based on locally agreed contracts.

3. Supporting Principles - 2004/05 Primary Medical Services Allocations Single Primary Medical Services allocation for PMS and GMS - to deliver primary care. PCTs will have flexibility in determining how they use their primary care allocations between GMS and PMS. PCTs will have some restrictions, such as: - the need to fund all primary care contractual commitments they have entered into deliver the floor on enhanced services; - meet key service targets.

4. Beyond these constraints, PCTs will be free to make best use of the funding available to them for primary care commissioning. PCTs will always need to be able to demonstrate that funding decisions between GMS, PMS and any other primary care contractual arrangements they enter into are fair, equitable and transparent. Alongside this increased flexibility, PCTs will continue to have a responsibility to live within their overall cash and resource limited resource allocation. The resources made available to PCTs for primary care services will cover funding for new PMS schemes, any new investment in existing PMS schemes, and to meet the appropriate and reasonable costs of practices that move between GMS and PMS contractual arrangements.

5. 2004-05 - Determining PMS Allocations to PCTs Key Documents AWP (2004-05) PCT 12 2003-04 PMS baseline allocation - determining 2004- 05 allocation baseline. AWP (2004-05) PCT 20 Confirmation of 2003-04 baselines. AWP (2004-05) PCT 26 2004-05 primary medical services allocations. HSC 2004/03 - Primary Medical Services Allocations 2004/05.

6. AWP (2004-05) PCT 12 2003-04 PMS Baseline Allocation - Determining 2004-05 Allocation Baseline AWP 12 informed PCTs of the final PMS Baseline position for 2003/04. PMS Allocations funded in 2003/04 from PMS Discretionary Budget. The PMS Baseline is made up of all 2003/04 allocations that had year-on-year implications, to include full year effect, and 2003/04 uplift of 3.225%. It excludes non-recurrent allocations.

7. The PMS baseline covers: - Main allocations for waves 1 to 5b; - In-year lump-sum allocation to support changes to in-year activity (exceptional changes and actual costs); - Additional funding for rent increases; - Contract Variations, including mergers and splits; - Allocation adjustments that support baseline activity year-on-year. The 2003/04 PMS Baseline excludes: - 2003/04 allocations for quality preparation payments; - 2003/04 allocations for flu, pneumococcal and HIB; - PMS funding in the Unified Budget.

8. AWP (2004-05) PCT 20 Confirmation of 2003-04 Baselines This AWP confirmed to PCTs the baselines that will be used to determine 2004/05 Primary Medical Services allocations. The PMS baselines include: - adjustments made to allocations as a result of issuing AWP 12, where applicable; - restated for full year effects, where applicable; - all non-recurrent funding removed. - 2003/04 allocation for Flu as notified to PCTs on 14 January. - 2003/04 allocation for Pneumococcal as notified to PCTs on 14 January.

9. The PMS Baseline - Main allocation for wave 1-5B - covering PA and dispensing, growth and the GMS to PMS transfer. - The 2003/04 uplift of 3.225% for GMS to PMS transfer, growth and PA and dispensing for non-dispensing GPs, and 9% uplift for PA and dispensing for dispensing GPs.

10. - In-year lump-sum allocation to support changes to in-year activity for exceptional changes and actual costs. - Additional funding for rent increases. - Contract Variations including mergers and splits. - Allocation adjustments that support baseline activity year-on-year. - Adjustments as a result of issuing AWP(04-05)PCT12. PCTs will be informed separately of these adjustments, via SHAs.

11. - PCO administered funding - the following items form part of the PMS baseline: - Designated area allowance - Initial practice allowance - Seniority allowance - Assistants allowance - Associate allowance - Locum allowances - Supply of syringes and needles - Sessional payments: Doctors Retainer scheme - Premises - PMS Premises funding covered actual and notional rents, and rates.

12. - Enhanced Services - Enhanced services that are included in the baseline are: - Contraceptive service fees - Minor surgery sessional payments - Childhood immunisations target payments - Pre-school booster target payments - Minor surgery fees (part) - Flu and Pneumococcal

13. AWP(04-05)PCT26 2004-05 Primary Medical Services Allocations HSC 2004/003 - Primary Medical Services Allocations 2004/05 The allocation as notified to PCTs on 6 February for Primary Medical Services covering GMS and PMS. For PMS - Annex H: - 2003/04 baseline - PA and dispensing - column A - PMS baseline (excluding PA and dispensing) - column B

14. Column B covers all baseline activity related to waves 1-5B PMS Schemes. - Growth - In-year funding (exceptional changes and actual costs) - Notional and actual rents and rates. - Additional rent - Contract Variations - PCT Administered funding - Some enhanced services - Flu - Pneumococcal Total restated 2003/04 baseline - column C

15. Increases/Uplifts - columns D-F - PA and dispensing - increases - All other Baseline activity (includes appraisal) - 3% 2004/05 Allocation - 2004/05 Allocation for PA and dispensing - column G - 2004/05 Allocation excluding PA and dispensing - column H - 2004/05 PMS Allocation - column I

16. Other Funding Streams Included in the PMS Allocation Premises - 2003/04 cash-limited expenditure on premises by GMS and PMS practices confirmed in AWP (04-05) PCT 18 and uplifted to 2004/05 prices. - existing commitments on premises by GMS and PMS practices confirmed in AWP (04-05) PCT 11 and AWP (04-05) PCT 15.

17. Premises - funding in the Unified Budget - cash-limited. - existing commitments as notified by PCTs. IT - funding in the Unified Budget - cash-limited. - £20m allocated in 2003/04. Quality Preparation Funding - based on fair share of funding available Appraisal - Fair shares/uplifts - based on fair share of funding available PMS - 2004/05 Other Funding Streams

18. Enhanced Services - PMS baseline - Flu and Pneumococcal - Enhanced Services Floor Practice Staff - Remains in Unified Budget (PMS only) PA and dispensing (PMS only)

19. Key Messages PCTs are expected to manage within cash and resource limit. No more funding to be allocated from the Centre for PMS to cover: - Growth - GPs/NPs; - In-year changes to activity (including rent, seniority and list size changes); - Contract Variations (including mergers and splits). Clawback PMS allocation - supports statement not to unpick PMS baselines Links to GMS - Primary Medical Services Allocation - Annex A.