ICB replaces APMS contract with GMS to secure ‘long-term sustainability’

An integrated care board is ending a GP practice’s APMS contract in favour of awarding a long-term GMS contract to the local primary care network (PCN). 

Since last year, The Limes Surgery in Hertfordshire has been run by Zenith Medcare Ltd, which is a company formed in 2021 by two of the practice’s salaried GPs. 

However, the Hertfordshire and West Essex ICB now intends to award a GMS contract to Hoddesdon and Broxbourne PCN in order to provide more stability to the practice. 

In its recent contract notice, the ICB said the ‘short-term nature’ of the current APMS contract disadvantages the ‘long-term sustainability’ of the GP practice, as it can result in several provider changes over a short period. 

This new contract, worth just over £897,000, will commence from February next year and has no defined end date.

According to the ICB, Hoddesdon and Broxbourne PCN is ‘capable of holding a primary care contract’ since it is a ‘legal entity’.

The PCN comprises three other GP practices in the area, covering around 42,000 patients, and it is run by a company – H&B Health – that was created to coordinate all of the PCN services.

Its management board comprises GP partner representatives from its member practices.

Hertfordshire and West Essex ICB’s contract notice, published last week, said: ‘It is HWE ICB’s intention, in line with Section 86 of the NHS Act 2006 and subject to Regulation 6 of the GMS Regulations to award this GMS contract to Hoddesdon & Broxbourne Primary Care Network (H&B PCN), who are a legal entity capable of holding a primary care contract and are a PCN network in which The Limes Surgery is located.

‘HWE ICB believes that the short-term nature of the current Standard Alternative Provider Medical Services (APMS) Contract which runs out on 31st January 2024 provides disadvantages to this practice such as long-term sustainability, with the potential for multiple changes of provider over a short period which may also impact on the development of the local Primary Care Networks and the wider primary care and continuity of care to patients.’

Following this publication, the official contract award will take place next week after a ‘10-day standstill period’. 

Prior to the current APMS contract with Zenith Medcare Ltd, the GP practice had been run by Lea Valley Health Ltd since 2018.

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’.

However in 2018 the BMA suggested CCGs were now switching practices from AMPS to GMS, through mergers, because AMPS contracts were too difficult to manage and ‘don’t deliver better quality of care’.

A Pulse Intelligence investigation from 2021 revealed that APMS practices receive almost £18 a patient – or 14% – more than their GMS counterparts.

Earlier this year, an ICB’s decision to award an APMS contract to a company in Lancashire drew widespread protest from patients who felt they had not been properly consulted.

Meanwhile, in June, the BMA’s GP Committee called for the PCN DES to be scrapped – a policy which the NHS Confederation criticised.

However, Pulse revealed last month that NHS England has no plans to scrap PCNs, and that the networks should feel confident continuing to recruit staff under the ARRS.