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Revealed: the hoops GPs will have to jump through for winter funding


negligence claims


Exclusive GP practices will have to submit ‘evidence-based’ claims to access £250m winter funding, such as payslips demonstrating staff have worked more than usual, NHS England has said.

In new guidance on the ‘winter access fund’ sent to systems this week and seen by Pulse, NHS England set out further details on the process for accessing the cash.

It said that eligible practices – which must fulfil the ‘gateway criteria’ of being identified by their ICS as ‘a practice in need of support’ from the fund and signed up to the pharmacy referral scheme – will have to submit claims supported by ‘robust’ evidence against set ‘criteria’.

The document said: ‘Practices or other service providers should submit evidence-based claims in line with ICS plans – no claims outside the agreed plans should be approved unless there has been agreement with NHS Regions to plan amendments.’

Evidence can include ‘payslips for the three months prior to the additional sessions being run – as evidence of the overtime baseline prior to the additional sessions’ to demonstrate that staff have worked ‘overtime’, it added.

Other examples of evidence are additions to current job descriptions or contracts of employment and payslips or other proof of payment for any new staff.

It said: ‘Claims should provide evidence that demonstrates how these interventions have supported improved patient access or experience – and that the interventions are additional to the services provided and paid for prior to the intervention and associated claim’.

ICSs and CCGs will review the claims using a ‘risk-based approach’ to sampling claims and ‘validating evidence supplied’, the document said.

‘Practices and other providers will only need to supply the evidence listed below if and when their CCG/ICS requests it’, it added.

NHS England will also monitor ‘progress’, with a process that ‘aims to appropriately balance the need for robust financial controls with the need to minimise the workload for ICSs and GP practices’, it said.

It will ‘review a randomised selection of practice plans each month, with more in-depth reviews triggered as appropriate’, it added.

Practices must submit claims ‘promptly’ and ‘no later than two weeks after the end of the month when the costs were incurred, with claims to be approved ‘within one month’, according to the supplementary guidance. 

However, ICSs can begin spending ‘according to their November plan on a provisional basis’ – ahead of formal approval of their ‘fully-costed system plans’, it said.

It added that each ICS will be allocated a ‘notional budget’ and will be ‘expected to manage the claims from practices and elsewhere in their system within that funding envelope’.

But funding can be re-distributed ‘as appropriate/necessary’ both within and across regions to ‘maximise expenditure’, it said.

The guidance set out that costs eligible to be covered by the fund include:

  • Funding more sessions from existing staff, locums or ‘other physicians
  • Expanding extended hours capacity, such as ‘any contingency planning for bank holiday working’
  • Using administrative staff including at PCN, federation or practice level ‘where commissioners agree that is what is needed and the optimal model’
  • Increasing the resilience of the NHS urgent care system during winter by expanding same-day urgent care capacity
  • Using primary care hubs such as respiratory hubs or 111 Clinical Assessment Services (CAS) capacity ‘where general practice is unable to expand’

Rates for any additional locum capacity ‘should not exceed £200 a session’ or £250 for out-of-hours work such as bank holidays and any higher rates must be approved by regions, it said.

ICSs can also identify ‘other supporting actions that improve patient experience or access’ to be funded by the package, it added.

Meanwhile, the guidance also said that ICSs must express an interest in the separate £5m security fund by 30 November in order to secure funding for their practices.

However, regions will have to ‘prioritise against their allocation using a risk-based approach to requests for practice security upgrades’, it added.

Under the £250m access plan announced earlier this month, ICSs were asked to submit a plan for tackling GP access challenges in their area – including a list of the 20% of practices with the lowest levels of face-to-face appointments to face ‘immediate’ action – by 28 October.

The BMA’s GP Committee has voted to ballot the profession on potential industrial action and called on practices to disengage from the PCN DES in protest to the access plan.

The BMA has also advised practices to immediately start offering consultations of 15 minutes or more; and apply to close their patient list, as part of the fightback against the plan.

READERS' COMMENTS [20]

Simon Gilbert 29 October, 2021 4:53 pm

If an organisation has been working flat out to manage demand but would benefit from more staff to get back to a reasonable long term work intensity for the same appointment numbers this presumably won’t be visible or eligible under this scheme!

Robert Davidson 29 October, 2021 5:14 pm

Rates should not exceed £200 / session. Hahahaha. We can’t get locums at all and on the few occasions we can they cost £350-£400 / session.

Luqman Rajput 29 October, 2021 5:16 pm

Excuse me, what?
200 for a locum session, I am sure there are a lot of locums waiting for this opportunity:(

Mark Leonard 29 October, 2021 5:17 pm

“Rates for any additional locum capacity ‘should not exceed £200 a session’ or £250 for out-of-hours work such as bank holidays”. These people are in cloud Cuckoo Land!

We can’t get locums in for £100 per hour at the moment.

Angus Ross 29 October, 2021 5:25 pm

Lots of monitoring by NHSE / ICSs / CCGs here. Presumably no need for them to provide evidence based claims for the cost of this extra work by their staff.
Maybe they just do it for nothing?

Decorum Est 29 October, 2021 6:05 pm

Simply not worth the bother!

Turn out The Lights 29 October, 2021 6:25 pm

Don’t bother nothing to see here,like pans homeopathic amounts of money for what it was meant to achieve.Whereas if it was second rate pipe or a track and trace system which was at best mediocre the amount of money was basically unlimited.Not worth the bother.Do they even know market rates for locums?If you even find one they wouldn’t bother either.When it come to NHSE and the DoH it more like the The Muppet Show.Another epic fail as GP land implodes.

Mudasar Khan 29 October, 2021 6:34 pm

Do we know what a hospital consultant charge an hour of locum? Without taking any extra work home or admin !!

Reply moderated
Doc Getmeout 29 October, 2021 7:30 pm

https://www.theguardian.com/society/2021/oct/29/nhs-facing-mass-exodus-gps-doctors-england-experts-warn

So nearly 1 in 4 could retired today with their pension – so for one’s wellbeing and mental health – now is time to go.

Patrufini Duffy 29 October, 2021 7:47 pm

You could just ___ stuff the funding, and push back the work and get out of the PCN and clock off early. Redirect anything like oil on water. Work smarter, not harder. Nothing ever is “funded” with good intention by NHSE, they’ll come and quarter you when you’re not looking, like they’ll do in your PCN contract, but mates rates for the rest of the £millions in back handers. Easily slip a contract or two here and there. Keep the hospital working and their private wings. Still waiting on dentist access data, nationally on the news please.

ANTHONY Roberts 29 October, 2021 8:32 pm

Current going rate for a GP locum is £90 to £100 an hour.
Time and a half to double time rates are usually needed to cover bank holiday sessions.
NHSE are not going to get much for their money.
I suspect all part of a cunning plan to blame someone else when it all goes pear shaped.

Adam Crowther 29 October, 2021 8:58 pm

Hmm same hourly rate as a locum SHO in ED after pension and NI 15 years ago. Not sure there are going to be any invoices to submit but am sure they will have taken on extra staff to process the claims 😂

Cameron Wilson 30 October, 2021 12:43 am

Well we certainly know how much our time and effort is valued! Forget breaking your necks for this lot like P.Duffy says just do the minimum and refer. Absolutely appalling it has come to this but we cannot be personally responsible to bail out the system! Suppose there are two camps, one who feels that riding it out and things sort themselves out or the camp that sees that the game is over and that a new healthcare system is required.. Will be interesting where we are this time next year!

C P 30 October, 2021 9:52 am

No bloody chance. Wouldn’t even waste the time to read the detail. Straight to recycle bin

Doc Getmeout 30 October, 2021 10:05 am

If the 1:4 GPs 55years and older of pensionable age become independent contractors (locums, they could demand 200-300£ hrly rates and work on their own terms.

This is the beauty of supply and demand market forces. The pricing power is shifted to Mr SJ.

The message to Mr SJ is find the money if you want the service going or close down!!!!

David jenkins 30 October, 2021 11:32 am

if you went to your local garage with, say, £250, and told them you wanted the full works, but the maximum you were willing to pay was £250, you would be told to “go away” (less politely, after the mechanic had got his breath back from falling about laughing) !

you would then either go away emty handed, or only have £250 worth of work done. everyone accepts this is how it works.

if NHSE, or whoever, approach you with the same request, you should do exactly the same – either fall about laughing and say no, or explain that this is what you will get for £250.

remember ken clarke’s famous words – “i want gp practices to run like businesses.”

some years ago, my uncle, a very sensible retired anaesthetist, was contacted by a hospital manager, who offered him £76 for a session’s work (morriston hospital, swansea).

his response……….”i prefer to go for a lie down in the afternoon”……and he put the phone down !

Dermot Ryan 30 October, 2021 12:37 pm

sign up to the pharmacy referral scheme: That means practices will have extra demands to corect the mistakes made by pharmacists: They are NOT clinicians. They clearly have a very powerful lobby group acting on their behalf.

John Glasspool 30 October, 2021 6:52 pm

Our solicitor charges us c £250/hr in NORMAL hours. TTFO.

Dave Haddock 31 October, 2021 9:37 am

Endless micromanagement from above is why the NHS is failing.

James Weems 31 October, 2021 10:29 am

Anyone know any locums doing sessions at 200 quid?
No? Thought not. Not realistic at all