PMS Premiums

NHS England’s Area Teams have started sending out letters regarding the review of PMS contracts. Except where local arrangements have already been put in place, these letters include a calculation of each practice’s “PMS Premium” and a request that the practice justify this premium or return to GMS (thereby losing the premium).

The calculation of the “PMS Premium” compares the income that the practice is receiving in 2014/15 with the income that would have been received if the practice has been GMS (based on the weighted list at 01/1/14).

It is important to check that the information shown on this calculation is correct, i.e.:-

•    Weighted list as at 1/1/14
•    PMS funding for 2014/15
•    Basis for the childhood immunisations figure used in the calculation of the theoretical GMS income
•    Basis for any additional services opt-outs shown in the calculation of the theoretical GMS income

Care should also be taken that the appropriate adjustments are made in respect of items of GMS income that may still be included in PMS income in certain contracts but have been unpicked elsewhere (e.g. premises funding, rates reimbursements or the dispensing fees element of PPA claims).

There are also 2 errors in the calculation of the theoretical GMS income that Area Teams are using, which we would advise you to challenge in all cases:-

a)    No account is being taken of the temporary patients adjustment that is paid to GMS practices
b)    The out of hours opt-out adjustment used by Area Teams is £4.02 per weighted patient whereas the true figure would be 5.46% of the Global Sum, i.e. £4.0163. Although this is a relatively small rounding error, it translates as £7 per 2,000 weighted patients and therefore should be challenged.

If you require assistance with checking the calculation of your “PMS Premium”, please e-mail the figures to us.