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CAMHS won't see you now

GPs better at clinical than organisational

GPs are suspicious that hospitals are deliberately obstructing practice-based commissioning in order to hang on

to their dominance over NHS finances.

LMCs said hospital activity data was riddled with errors making it impossible for GPs to agree indicative commissioning budgets with their PCT.

The errors in codes, which correlate with Payment by Results national tariffs, meant some hospitals had claimed up to 10 times more for a procedure than should have been due.

GPs said they feared 'games were being played' in particular by debt-ridden NHS trusts that were deliberately miscoding cases in order to claim more money from PCTs.

The reports come after Pulse reported GPs were snubbing practice-based commissioning and PCTs were 'paralysed' by Government demands for wholesale mergers.

Dr Nigel Watson, Wessex LMC chair, said some PCTs were saying they did not even possess hospital activity data for practices to use.

Where data was supplied, GPs had identified cases where hospitals had wrongly coded activity, resulting in claims for 30 per cent more than a procedure should have cost.

'The data is not very accurate,' Dr Watson said. 'There are games that could be being played and where there are cash-strapped trusts that is a concern.'

Dr Peter Joliffe, chief officer of Devon LMC, said GPs had found cases where hospitals had billed PCTs for procedures that cost thousands of pounds when the treatment should have cost hundreds.

He said: 'This sort of thing is coming through. I hope it's cock-up not conspiracy.'

Dr Richard Vautrey, a GPC negotiator, said he believed data problems were due to incompetence. But he said practices could not take on commissioning unless they had accurate data.

He said: 'If trusts are manipulating it that must be exposed.'

Dr James Kinsgland, chair of the National Association of Primary Care, said it would be 'an incredible indictment' of the NHS if hospitals were gaming the system.

It was because of PCTs failure to manage commissioning that GPs were needed to sort out the mess, he said.

By Ian Cameron

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