1. Director 020 7274 8813 mark1wilson@yahoo.co.uk

2. Contracting for Primary Care

3. PCT Strategic Functions
The general modernisation of primary care
The expansion of the primary care sector and the resourced shift of secondary to primary care work
The recruitment and retention of the primary care workforce
The management of demand for primary care services

4. Patient Services Guarantee
PCTs will have a legal responsibility to ensure that:
‘patients will continue to be offered at least the range of services that they currently enjoy under the existing contract’

5. Process Develop commissioning strategy Undertake procurement process
Monitor outcomes

6. Contracting Routes - Summary

7. GMS Contractors A general medical practitioner
Two or more individuals practising in partnership;
At least one partner (who must not be a limited partner) must be a general medical practitioner
Other partners must be individuals from within the NHS family
Company limited by shares
At least one share must be legally and beneficially owned by a general medical practitioner
Other shares must be legally and beneficially owned by individuals from within the NHS family

8. PMS Contractors
Agreements can be made with one or more of the following:
An NHS Trust
A medical practitioner
A healthcare professional
An individual who is a GMS or PMS provider
An NHS employee or a PMS employee
A qualifying body (a company limited by shares, all of which are legally and beneficially owned by persons identified above)

9. APMS Contractors
PCTs may make contractual arrangements with any person (for the provision of primary medical services)
[Section 16CC(2)(b)of the National Health Service Act 1977]
Specific provisions for:
Individuals
Companies
Partnerships
Industrial and provident societies, friendly societies, voluntary organisations
ie. must be fit and proper persons.

10. PCTMS
A PCT may provide primary medical services itself (whether within or outside its area)
[Section 16CC(2)(a) of the National Health Service 1977 Act]

11. PCTs as commissioner
Three routes:

12. PCTs as provider Two routes: PMS PCTMS
“ Under PMS, the PCT can be the contractor but this involves the SHA acting as the commissioner. The SHA commissioner role is increasingly anomalous given StBoP and PCTs may ... wish to transfer such PMS contracts to PCTMS arrangements where the PCT is the direct provider.”
[para 2.6 Delivering Investment in General Practice]

13. PCT Provision
“ PCTs are encouraged to develop a minimum level of (provision of essential) services....
If PCTs propose to become large-scale providers of primary medical services, they are expected to discuss this first with their SHA. They are also expected to consult with LMCs.”
[para 2.6 Delivering Investment in General Practice]

14. Procurement Process Two stage process:
First, competition between GMS and PMS practices (which would have preferred provider status);
Then, open competition.
[para 7.20 Investing in General Practice]
Further Guidance ?