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PMS practices face QOF clawback after calculation error

Exclusive PMS practices will have a surprise reduction in their QOF payments for 2013/14 after a NHS England admitted a calculation error meant their estimated payments were overvalued by thousands of pounds.

Pulse has learnt that out-of-date information on average list size was used in the new calculating system resulting in incorrect QOF payments being displayed on the Calculating Quality Reporting Service (CQRS).

The mistake came to light as Pulse revealed GP practices across England have been hit with incorrect estimates of their QOF payments for 2013/14 after a calculation error in CQRS meant thousands of pounds were missing from their payments.

NHS England sent a letter to area teams last week explaining that a PMS practice with a 6,200 patient list would have its deductions undervalued by around £2,300 due to the error.

A letter from Essex Area Team to practices explains: ‘All area teams have been notified that an error has been made in the PMS deduction. The error is due to the changes to the Contractor Population Index (CPI). Since 2004 the CPI has not changed so the PMS deduction calculation has remained the same however with the increase in CPI the PMS deduction has been affected.’

A spokesperson for NHS England explained: ‘Letters have been sent to area teams advising them of financial adjustments needed to ensure practices receive the money to which they are entitled. No practice will be disadvantaged by this move which affects the calculation of 2013/14 QOF achievement payments.’

Bob Senior, head of medical services at Baker Tilly accountants told Pulse that PMS practices are likely to be completely unaware that they will have their QOF payments reduced by thousands of pounds.

He said: ‘I suspect most of them hadn’t sat down and worked out the precise amount. And it was only when they plugged the numbers into this QMAS replacement software that it told them what they might be getting from the QOF, that they first thought: “Oh that’s better than what we were hoping for,” only to find out that, actually it’s got to come down by x amount.’

Readers' comments (1)

  • How can anyone tell, without the calculations behind the payments. The bits of CQRS I can access doesn't show how prevalences are calculated, or any calculations. However bad QMAS was, at least you could get the figures on how the calculations were made.

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