Exclusive GP practices in some areas have been given a cash boost worth £1 per patient by their CCGs, to help cover the extra costs of managing the Covid-19 pandemic response.
This comes as details of a ‘General Practice Covid Support Fund’ touted by NHS England have not materialised, leaving GPs with uncertainty about cash flow.
Kent LMC told Pulse the payment by NHS Kent and Medway CCG – described as an ‘emergency cash injection’ – was made to ensure practices had short-term financial support while waiting for national funding to come through.
Similarly in Essex, practices have been told that ‘in the absence of guidance or any clarification of timescales, Basildon and Brentwood CCG has made an interim payment to primary care to cover additional costs incurred as a result of managing practices Covid response’.
It comes as local GP leaders warned GP practices were facing cashflow problems and could end up ‘out of pocket’ after having to pay for extra staffing and equipment while usual practice payments were being held up.
LMCs and CCGs are advising practices to keep a record of all expenditure related to Covid-19, in order to apply for reimbursement pandemic related costs in future.
Kent LMC advice to practices states: ‘CCGs are being asked to support a monthly cycle of reporting Covid-19 related expenditure. It will be important that practices should keep a record of such expenditure, in order to advise the CCG and to serve as the basis of any additional claim for support that may be necessary.’
Elsewhere, Humberside LMC is similarly advising practices: ‘Keep track of money spent on additional staffing, sick pay, locums, or any equipment that you have needed to purchase specifically for the current pandemic.
‘NHS England / Improvement have committed to practices being able to claim back such costs but we do not have any detail regarding how or when this will happen.’
Practices have been assured by NHS England that their funding for any work that is suspended while they manage the crisis, such as local enhanced services and QOF, will be protected.
However, it remains unclear how extra staffing and other costs due to managing the Covid-19 response will be reimbursed.
Kent LMC medical secretary Dr John Allingham told Pulse the LMC had been receiving ‘lots of questions about cash flow’.
Dr Allingham said: ‘The agreement to carry on funding QOF and enhanced services against historical levels is good, but some of the money isn’t flowing because the normal route by which you claim doesn’t quite exist and the system is slow to react.’
He added: ‘A lot… has been set up on donations and personal things and the same with the staffing levels. So there is guesswork and if we get it wrong and if the [NHS] won’t reimburse, people are going to end up out of pocket.’
NHS England declined to comment or provide a response on when details of funding for extra pandemic costs would be released.
An NHS England bulletin to primary care dated 7 April noted that, in addition to reimbursing costs of staffing Easter opening, ‘further costs incurred as a result of the pandemic will be addressed in due course’, while a subsequent NHS bulletin on 8 April added: ‘Details of the General Practice Covid support fund will soon be shared, and additional expenses will be considered within this.’
The BMA told Pulse it ‘is continuing to press NHSE/I for these details and will provide clarification when we can’.
Cash injections in Kent and Essex
The emergency payment from NHS Kent and Medway CCG was made at the end of March and based on practices’ January 2020 patient list size, with 60p out of the £1 per patient an ‘unconditional’ payment to cover costs already incurred, while the remaining 40p per patient is to be used for further costs as needed.
A joint letter to practices, from Kent LMC chair Dr Gaurav Gupta and Kent and Medway CCG chair Dr Navin Kumta, stated: ‘[The CCG] will make a one off payment of 60p per patient, based on the January 2020 raw list size, which is unconditional and will be retained by the practice to cover costs.
‘The CCG will, in addition to the 60p above, and in order to help with cash flow, make a further payment on account of 40p per patient based on the January 2020 list size for cost that you may have incurred over and above the first 60p, which is currently being modelled to reflect the differing needs of practices.
‘This means practices will be receiving an additional £1 per patient to help cover the challenges of responding to Covid-19.’
The LMC told Pulse that practices must use the additional 40p per patient only for Covid-19 related costs, but that it was ‘unlikely’ this would mean practices having to pay back any unused funds.
Kent LMC deputy clerk Carlo Caruso said: ‘Although it is possible that the 40p would have to be returned, I think it is unlikely. Many practices I speak to are finding responding to the pandemic is causing pressure on finances.’
Meanwhile an email from Basildon and Brentwood CCG chair Dr Boye Tayo to member practices, seen by Pulse, advised: ‘The CCG is very aware of the rapid transformational changes primary care providers have made in order to deliver as comprehensive care as practical during this period.
‘In recognition of the additional costs incurred… in order to deliver this change and sustain the level of care, the CCG has agreed to make £300k of additional funding available to practices. This has been split on a pro rata basis. This is in recognition of costs incurred by practices thus far in the management of the response.’
Each practices’ share of the £300,000 works out at £1.06 per patient. The CCG said it expects this additional payment to cover costs incurred up to April 30th 2020.