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GP practice 'owed £100k' since NHS England overhauled payments system

Exclusive A 7,600-patient practice is claiming to have been left without £100,000 in assorted payments this year because of upheaval since NHS England scrapped local payment offices for a national system.

The Village Practice in Islington, North London, is missing rent, pensions and seniority payments, as well as immunisation reimbursements amounting to a six-figure sum, it has told Pulse.

Practice manager Amanda Meehan said she began raising concerns with NHS England and Primary Care Support England (PCSE), the GP support service function provided by Capita, in October.

Capita told Pulse that it had ‘clearly communicated’ all the new arrangements for payments to practices, but delays had arisen where these were not followed.

Ms Meehan said she was unaware of any warning, and told Pulse that the first she knew about the changes was when the practice's monthly rent reimbursements stopped being made, followed by changes to timings of several other regular payments.

She said: 'Together with the non-payments it was crippling. To give you some idea, we are owed £100,000 in missed payments. I’ve logged complaints, nobody responds. It doesn’t do anything.'

The practice claims that outstanding payments include:

  • Rent and premises reimbursements not paid in 2016/17 - £65,000

Which Capita told the practice ‘will need to be sent directly to NHS England’, though Ms Meehan said invoices last year, resubmitted in January, are still unpaid and NHS England had directed them to Capita.

  • Seniority adjustments from 2015/16 - £8,000 (As reported to Capita in November 2016)

Which Capita said ‘was paid over to the practice in January 2017’ but which the practice has previously told them ‘the payment was not right'.

  • Pensions refund - £7,275 (as of November 2016)

The Capita pensions team have asked for ‘further details' before they can process this but, again, Ms Meehan says she has submitted the earnings reports three times already.

  • Child immunisations reimbursements (Agreed in writing with the local support services office prior to its closure) – £11,000

Capita explained they ‘no longer calculate adjustments for childhood imms’ and any late claims would be made at ‘NHS England’s discretion’. But the practice already has a written agreement with the previous local support services office which has not been honoured.

Ms Meehan told Pulse: ‘I know about ten practices in Islington who are all missing seniority, pensions, all the same things. And we are among the most deprived areas in the country.

‘To leave us without this kind of money is unforgivable. But to palm us off like this, what kind of small business can operate without this kind of funding?’

Pulse has seen emails between the practice and NHS England’s London office which show both parties have repeatedly escalated complaints to PCSE.

In one email, an NHS England (London) finance manager says it 'is not in our interest to destabilise a practice financially' but asks the Village Practice to be patient with the delays as the regional team only recently found out it would have a role in processing some of these payments following 'late advice from Capita'.

A Capita spokesperson told Pulse: ‘Under the previous arrangement, local support offices were responsible for a number of payment processes which were not transferred to Capita.’

‘We and NHS England have clearly communicated the changes and new arrangements to practices. We are working with the practice to resolve the issues that we are responsible for and supporting them to resolve any areas that are now the responsibility of NHS regional teams.’

NHS England did not resond to a request for comment.

Support services disruption

NHS England’s own review of the first seven months of the Capita contract found that hundreds of practices had missed payments.

And these cases occurred before Capita began overhauling services, with many practices contending with significant disruption to payments, pensions, supplies and patient notes since March last year.

At the end of last year, the GPC warned that the service was still a ‘chaotic mess’ but practices have yet to be compensated for the disruption and additional workload they have suffered.

Last month, NHS England pledged that ‘significant improvements’ to general practice support services will be completed by April, as it seeks to return the services it outsourced last year to ‘acceptable’ levels.

But by then practices will have endured more than year of disruption, after Capita took over as NHS England’s national provider of primary care support in September 2015.

The move followed an NHS England cost-cutting drive where it slashed its £100m-a-year support services budget by 40% and has resulted in huge backlogs of patient records movement, delays registering new GPs and missed payments.

Readers' comments (13)

  • If your Open Exeter Statement reads 'Total payment Units'= 5000 but NHSE pays you for 3500 which is your weighted list size, you are being underpaid more than a 100000 per year. If this has been going on for more than 4 years the total underpayment is almost 500k. However, NHSE tries to get away by saying they don't understand and PCSE is responsible. PCSE sends the mail back saying NHSE is responsible and you you go on between them for 3 years because in the NHS corruption is rife and there are people of shady backgrounds who feel they are above the law. NHSE has lost a couple of cases due to it's arrogance and false sense of omnipotence. Waterloo is nigh and it's positive that Village Practice is fighting it out. In Kent and Medway they would have had a more uphill task due to congenital lack of transparency.

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  • Easy-contact a debt company and get the bailiffs in!
    Send them to CAPITA headquarters in a big white van and let them do their job....that is what any other normal business would do.

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  • Not that easy, a debt company wants proof that you are owed but you are dealing with a mafia where one one agency send you to the other and the second to the third. Open Exeter chap said he confirms that data is being 'manipulated' at the local level but can't give it in writing because' his boss will be upset'- this was two years ago. Nobody in this country can explain why the Total Payment Units on your Open Exeter statement are not being respected. You would probably need a Wikileaks to unravel a system which even MI5 would not be able to clarify. That is the level of hideous complicity in NHS in Southeast.

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  • Easy - go to court

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  • My practice is in the same situation.
    We are owed about £65000 by NHSE. Pension contributions for salaried doctors who have left general practice are still being deducted from us. Also rent arrears not paid.

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  • It is bizarre the way we are paid. All the problems of being self employed but none of the benefits

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  • Horoscope,Please can you give reference names for two cases you describe as I have had similar problems.

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  • This is where I believe the medical indemnity companies who pay themselves so handsomely,should be providing us with FULL legal services including cover for contractual disputes..... and if the RCGP actually had a spine, and started its own legal/indemnity branch, should be piling in there, and if no satisfactory result is obtained quickly should be pulling services by ALL GPs in the affected areas until the despite is resolved...... in the interim patients have to go privately until NHS funding has been restored....

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  • London LMC involved at all? Sounds like a total nightmare.

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  • That sounds like a total shambles

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