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Independents' Day

'Hundreds' of practices denied DES funding worth tens of thousands over 'minutiae'

Exclusive GPs have said that ‘hundreds’ of practices in some areas are being denied funding worth tens of thousands of pounds for the patient participation enhanced services as a result of local area teams imposing a hardline stance on what they must achieve, Pulse has learned.

GPs have said that NHS England has withheld payments for the DES for 2013/14 because practices did not follow the specification to the letter in all of its six component parts, representing a shift from a more lenient stance in previous years.

In South Yorkshire, half of all practices have been affected, LMC leaders said, while similarly ‘hundreds’ of practices are affected in London.

The DES – which is worth £1.10 per patient – finished in March 2014, and required practices to issue reports on the make-up of their group, run patient group meetings and surveys, analyse results and form action plans with their patient groups.

But practices have said that a failure to adhere to the ‘minutiae’ of the DES meant NHS England was withholding the whole payments from practices.

Dr Dean Eggitt, chair of Doncaster LMC, said a GP practice in South Yorkshire lost £10,000 worth of funding when it failed the DES because it uploaded the contents of its report to its website, rather than creating a report in an accepted Word or PDF document.

Meanwhile, a GP at a practice in north London, who wished to remain anonymous, said the practice was not paid for 2013/14 because it failed to include a patient group age and ethnicity profile in its report.

Dr Eggitt said: ‘I am not sure with regards to other areas but in South Yorkshire it was almost 50% of practices that were not paid. That is quite a large number and the decisions have been based on minutiae. One of the practices in our region has missed out on the patient participation DES because they had not called their report a report.

‘Instead what they did is they put it on their website in an easy-to-read format for the patients. But because that wasn’t a formalised report in a Word document, or a PDF document, they didn’t get the payment. For that practice, that was worth about £10,000.’

The north London GP said that the local area team had withheld payments from their practice.

The GP said: ‘Because of the exact wording of the DES, hundreds of practices are being told they are not receiving any payment for the patient participation DES for 2013/14. There are six components to the DES and in our case we missed writing a paragraph detailing the ethnic/age profile of our patient group in our yearly report for component one.

‘As a result NHS England is not paying us for that component or any of the subsequent five components – never mind that these have been completed fully, via patient group meetings, running surveys, analysing results, discussing with patient groups, forming action plans and carrying out the actions.’

The GP said that Camden LMC was making representations to NHS England about the ‘unfairness’ of the decisions.

The GP added: ‘This DES is worth £1.10 per patient, which is a significant amount of money for practices struggling with workload and falling income. Frankly it’s a kick in the teeth to all the practices who have gone the extra mile to incorporate patient groups and involve them in the running of the practice. I know of many practices, including our own, that will ditch the DES for 2014/15 if this is not resolved.’

An NHS England spokesperson said: ‘Practices are being paid in accordance with the financial rules set out in the Statement of Financial Entitlements. It is for area teams to determine if enhanced services payments are due and whether or not practices have achieved the specified criteria. There is of course an appeal process if a practice feels that it has been treated unfairly.’

The respective area teams were also approached separately for a comment, but they said only NHS England’s national press office would issue a statement.


Readers' comments (16)

  • I am no supporter of NHSE/CCGs etc, but come on, the practice signed an agreement to do X work and then get Y payment. Plenty of is did do all the rubbish box ticking and got our payment, why should those who didn't, expect to also get paid? Both sides need to comply with the terms of an agreement.

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  • It is the spirit of an agreement which matters most, not the nit-picking details. Why is it that we GPs are always expected to bend, and not work to the letter of our contracts when it's in the patients' interests (such as when strictly speaking the patient could come to the surgery but we choose to do a visit instead), but so often find jobsworths in the management side ready to deprive us of income on mere technicalities?
    Is there not a concept in law about 'fair behaviour and best intentions' that could be brought into play here?' (I'm afraid I can't remember the specialised legal words.)

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  • Our letter said we failed all components because we had failed component 1. It was pointed out that as we had taken part in the DES in 2012/13 we did not need to comply with component 1. They then said that when our submission was checked our website link did not work (I had an email from March confirming receipt of documents and that the link worked) but that they had tried it again and it did work. My submission is now being checked again. This whole thing appears to be an attempt to not pay Practices and despite what the sanctimonious PM above has said, there is no way a whole year's hard work should be forfeited because of small, unimportant omissions.

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  • However hard you try they will always find a way of clawing money back from us after all that is what this whole execise is about isnt it?

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  • Like the practice in the article we've worked really hard with our patient group this year. Held meetings, ran surveys, analysed results, created action plans with the group and then took the actions forward. Yet because we omitted to write a paragraph in our report detailing the profile of the group we are not being paid a penny for the whole of the DES and have failed all components. Is this fair.

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  • We had a DES declined because apparently they did not receive one form on time - despite it being hand delivered on time by our practice manager - they knew we had done all the work - the rest of the paperwork was fine - but because we had no receipt for the hand delivery they would not accept we had delivered it and they had lost it - so we lost a few thousand pounds!

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  • But these enhanced services have never been about the work that you did and what you achieved. They have always clearly been about form filling and box ticking. Yes it's awful, but that's what you get paid for, not for being good or right or hard working. You have to work to what you get paid for, not what you think is the right and moral thing to do. The ES always said what minimum work you had to do and what forms must be completed by what date. Doing lots of extra work and not completing the forms is good and caring and moral but the money was never for that.

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  • We had ours declined as well . They looked on the totally the wrong practice website and judged us on that !!

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  • we didn't do it - we have ppg but declined the paperwork and handing control over to the ppg.

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  • This does seem like a back door way of clawing back money from practices. Yet another financial pressure. It's disappointing to read and sad to think that we should fall foul of technicalities in this way.
    Maybe the area teams will be less pedantic this year as many are smaller and surely less capable of picking practices up on such issues.

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