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Practices across England to have trade waste funding withdrawn

Exclusive NHS managers have told practices they will have to pay for the removal of their trade waste as NHS England cuts down on discretionary payments.

The removal of trade waste had traditionally been paid by most PCTs, but local area teams in areas where practices were reimbursed have begun withdrawing the payments.

Merseyside local area team sent a letter to practices stating it will withdraw payments, which it told Pulse was in line with the policy across local area teams.

GP leaders said that this ‘not inconsiderable’ expense was being withdrawn across the country, and criticised NHS England for putting more financial pressure on practices.

The GPC is currently in the middle of negotiating changes to the premises costs directions, which states what are discretionary payments.

PCTs had traditionally paid costs for the removal of trade waste, but some PCTs – such as Derbyshire - had started withdrawing the payments before their abolition.

The letter from the Merseyside local area team to practices said: ‘I am writing to advise you that with effect from 1 April 2014, NHS England will no longer fund Commercial or Trade waste services for practices.’

‘The Premises Directions 2013, Part 3, paragraph 46 (1) (b) lists the payments NHS England has a duty to make, this excludes the collection and disposal of Commercial/Trade waste.’

A statement from the area team sent to Pulse said this was consistent with the approach across England.

It said: ‘In other parts of country LMCs have supported negotiation with trade waste companies to arrange cheaper cost for practices in light of the Premises Directions.  The action taken by the Merseyside Area Team is consistent with other Area Teams.’

GP leaders said this was an issue across England.

Dr Bob Morley, chair of the GPC contracts and regulations subcommittee, said: ‘Different PCTs had different arrangements. There is an obligation under the regulations to reimburse disposing clinical waste, but that doesn’t apply to trade waste.’

‘I am aware that historically some PCTs were reimbursing it, it was on a discretionary basis so it is hardly surprising that NHS England nationally are cutting down on anything they consider to be a discretionary payment.’

‘It is yet another expense that was historically being provided to practices.’

Dr Rob Barnett, chair of Liverpool LMC, said that Merseyside had continued to reimburse while others withdraw the funding.

He said: ‘It could be argued that we have been lucky where we are, that we have been getting that reimbursed.’

‘My understanding is that this is not a local issue, it is a national issue. The only way it will get resolved is by getting the premises cost direction reworded.’

Dr Ivan Camphor, medical secretary at Mid Mersey LMC, said: ‘It’s not an insignificant amount of money. It will be considerably amount of money that they will have to budget for again.’

‘With underinvestment and no sign of any recovery, it seems absolutely disastrous that people want to remove any more investment from practices.’

Dr David Geddes, Head of Primary Care Commissioning at NHS England, said: ‘We are aware that many PCTs and subsequently area teams have reviewed the arrangements for paying trade waste and a number have now taken the decision to no longer offer reimbursements as a result of competing priorities for primary care resource. We will pick up the implications of this within our discussions with the GPC.’

This is not the first discretionary service being cut by NHS England, which has already said it will stop funding GP occupational health services unless there are performance issues. GPs have also complained of withdrawn payments for maternity and paternity locum cover, as NHS England was reviewing all payments.

Please note: story incorporated Dr David Geddes quote at 11:23 on 25/02/14

Readers' comments (20)

  • I have quite a large bonfire in my back-yard - is it OK just to burn it?

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  • I can think of where to put the waste - a big skip called Westminster.

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  • Peter Swinyard

    We are nearing the point in many practices where the "discretionary services" we provide - ie anything not in the contract (which I know varies from GMS to PMS) - may have to be withdrawn.
    Every little straw threatens the spinal integrity of the camel.

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  • Our income is down by 20%, our electricity and gas expenses have gone up 400% (since the transfer from PCT to NHS estates) due to error in calculations. We have decreased our monthly drawings twice in last 6 months. My income as a full-time GP partner is less than that I earned as a GP registrar.
    GP land is at breaking point, as there is a GP shortage best to leave NHS ASAP.

    Because GP services are so inexpensive the government thinks we are cheap. It costs £55 to see a nurse in MIU to the government/CCG but that's what we get paid for unlimited number of appointments for multiple complex issues.

    GPC kindly don`t negotiate this as something else will be imposed soon, Just walk out and ask for HRG tariff for GP`s per contact e.g 10 min face to face consultation, telephone consultation, 5 min consultation, home visit, nurse appt etc. This is the only solution the government will understand.

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  • Wholeheartedly agree with the above comment. Here here. Time for action. Straw that broke the camel's back.

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  • I agree with Peter. Yes, this sin't in our contract so no one is going to argue against it going.

    But same could be said for "good will" service we provide as well - next time perhaps I should be more prescriptive and refuse do a visit that cannot be completed before 6:30pm?

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  • Next year practices will have to pay for IT other than the cost of their clinical system

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  • Chris Kenyon

    Does NHS England pay for disposal of hospital waste? Will that also be withdrawn?

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  • Vinci Ho

    Told you
    NHSE is Minister of Plenty (1984)

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  • We should adopt a not in our contract mentality .
    These payments although not contractual are part
    of practice funding as a whole ....
    Time increase our charges on what we can
    Such as medicals ect?.

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