APMS firm got 10% pay boost
By Steve Nowottny
Exclusive: A private company received 10% extra over the value of its core APMS contract through a single local enhanced service-style payment in the first year of running a GP practice, Pulse can reveal.
Creswell Primary Care Centre in Derbyshire, which was taken over by the company ChilversMcCrea Healthcare in 2007, received a payment of £63,906 for ‘Note Summarisation' in 2007/8, details released under the Freedom of Information Act reveal.
ChilversMcCrea said the funding was prompted by the ‘exceptional amount of work' required to summarise notes after taking over the village practice.
But local GPs have raised concerns that the payment, which was not offered to any neighbouring practices, was far above the going rate and indicative of preferential treatment for the private sector.
The payment for note summarisation represents 10% of the total value of Chilvers McCrea's contract, which a separate FOI response has disclosed was £631,833 in 2007/8. The payment equates to roughly £10 per patient.
However, in the following year, 2008/9, the practice scored poorly on four QOF indicators relating to notes summarisation, being awarded 0% for an indicator on whether it had up-to-date clinical summaries in at least 60% of patient records.
Dr Trefor Roscoe, a GP in Sheffield who worked as a registrar in the Derbyshire practice 20 years ago, said: ‘We pay our summarisers about £6 an hour, and they do four or five sets of notes an hour. That's the going rate. I suspect ChilversMcCrea has said, "there's no way we can take this practice on – the notes are a mess and we need some money to sort it out". The trust has added 10%, but this is money the public purse should not have had to spend.'
A PCT spokesperson said the payment was ‘not a formal LES' but had been listed as such in its FOI response ‘to be fully transparent'. ‘As it wasn't a formal LES, it wasn't offered to other practices,' the spokesperson said.
The trust declined to comment on whether the funding was over the odds, but said it ‘was to reflect the need to improve the notes [Chilvers McCrea] inherited'.
Asked about its subsequent QOF score, the spokesperson said: ‘This process has only just been completed and payments to the practice reflect this.'
Dr Sarah Chilvers, managing director of ChilversMcCrea, said: ‘When we took over the practice, an exceptional amount of work was required to bring the notes up to standard. This work has helped us to significantly improve access to healthcare for patients.'
Dr John Grenville, secretary of Derbyshire LMC, said: ‘On the face of it, it looks very discriminatory. But although they've listed it as a LES, it's an APMS contract so LESs don't really count. Because the definitions are so different, it's impossible to tell if the playing field is level.'
ChilversMcCrea, which manages over 30 practices across the UK, has endured a difficult few months. Earlier this month NHS North East Essex threatened to remove its APMS contract for a local practice after accusing the firm of ‘underestimating' the challenge of running GP services.
In April, the company was forced to terminate its contract for a practice in south-east Essex, blaming the economic climate.Dr Trefor Roscoe: money the public purse shouldn't have had to spend Dr Trefor Roscoe: money the public purse shouldn't have had to spend