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NHS England launches investigation into missing DES payments

Exclusive NHS England is ‘urgently investigating’ issues that have seen GP practices around the country underpaid by thousands for the Avoiding Unplanned Admissions DES.

The stance marks a change from earlier in the week, when NHS England claimed that GPs who said they were missing thousands of pounds had ‘misinterpreted’ the DES requirements.

A spokesperson told Pulse that NHS England is ‘investigating [the problems] as a matter of urgency’ and would have more details soon.

Payments for the DES have been hit by a myriad of problems, with IT systems not logging care planspractices having to manually enter records of patient deaths and CQRS failing to collect data on achievement.

Since Pulse reported the issues with the DES payments – with the GPC claiming practices were losing up to £1 per registered patient – a number of GP practices in different parts of the country have come forward with reports of new issues.

A GP in Sussex said that the systems ignore care plan reviews prior to March 2015, meaning that even reviews ‘in the last 12 months’ were ignored.

A GP in Buckinghamshire told Pulse that a local investigation concluded that NHS England had failed to update guidance on which Read codes should be used.

NHS England told Pulse it was investigating a range of problems in cooperation with the Health and Social Care Information Centre, which is responsible for updating IT system providers based on information supplied by NHS England.

An HSCIC spokesperson said it was working with area teams and IT suppliers to address ‘unconfirmed reports’ of practices missing achievement targets against their expectations, and that it was advising practices to approach their area teams for local solutions.

But GPC deputy chair Dr Richard Vautrey said the missing payments was a ‘general issue’ happening ‘quite widely’.

He said: ‘We have made very strong representation to senior people within NHS England that they have to sort this out.’

One practice in the east of England told Pulse that it was missing £10,000 in funding, with its report showing it had apparently registered zero patients who were most likely to have an unplanned admission, despite having in fact registered the 2% of its list as required by the DES.

GPC negotiator and Essex LMC chair Dr Brian Balmer said his LMC had made a request to the area team to pay practices based on their own records of their achievement, to prevent serious cash flow issues, but this was blocked by NHS England in the absence of a national solution.

He said: ‘We asked them to make the payment based on practice’s accounts [but] NHS England said we should not agree local actions ahead of a national solution. So because of this national instruction, the [area team] has completely thrown out our suggestion.’

Meanwhile, GPs in London were advised that they could ‘send NHS England a screen shot of their clinical system’ to prove their record of their achievement.

Readers' comments (6)

  • Russell Thorpe

    Anyone else nostalgic for the old "Red Book" when we understod what we were being paid for, how much you got and you could check the quarterly return. We used to get 1 strip of pink paper with all the payments listed in order.

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  • Try the back of Osbournes sofa, there's billions down there!

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  • I have always maintained there is no transparency the system and despite raising issues for a couple of years it is even difficult to get a response of explanation. It is not just NHSE conducting an investigation, it's NHSE that needs to be investigated urgently.
    I'll reiterate my Audi experience where from the first week I raised issues with problems and only after 3 years VW got implicated after I had managed to sell it off. Let the government investigate NHSE now because otherwise they won't know what proportion of damage to Primary Care was caused by budget mismanagement at the regional level.
    Raising concerns gets you dubbed a trouble maker but somebody has to poke the stick in the hornet's nest:)

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  • This is all deliberate
    It's been happening for years and nothing has been done this far.

    The whole GP payment system is garbage. I could never understand the "historical" bias that meant next door practices were paid more than some for a similar population , demographic and workload.

    As for missing payments don't even get me started!

    The whole of the system in the uk is designed to wear you down and make you capitulate.

    You spend so much of your precious time doing tasks that really are beneath you that by the time you get home you're exhausted.

    Luckily I was able to simplify all this uber shite by emigrating. Simple fee structure and bill insurance or govt. paid on time every time . Paid the same as a colleague up the street for the same work.....I give patients hospital numbers so they can book their own appointments and chase results themselves etc and have them sent to me and tell them that they are their own best advocates, so I'm not wasting my time. No home visits, no nursing home visits, no ooh no red eye, no GMC, NO CWC, no machester muppets with their moronic interference. No spiteful media. Easy least now I just concentrate on medicine!!!!!

    The simplest solutions are often the best!!!!!!!
    Up yours nhse

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  • 5:05

    I'm looking forward to the Manchester Muppets Christmas Carol. Ebenezer Hunt wants us all to work on Christmas Day. God bless us every one!

    Tiny Tim

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  • I just hope GP land collapses. With NHSE, Hunt, Field, CQC, GMC, why does anyone want to be a doctor, let alone a GP in this country?

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