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GP payments chaos will be resolved ‘by next April’, NHS England says

Exclusive Ongoing problems with practices receiving incorrect or late payments which have forced some GPs to take out overdrafts and others to be threatened with court summons will be resolved by next April at the very latest, NHS England’s head of primary care has promised.

Dr David Geddes told Pulse he was unable to give a precise timescale for when NHS England expected to resolve the payment problems which have dogged practices since the handover from PCTs in April – but did offer a ‘cast iron’ guarantee that the issues would be cleared up within the next four and a half months to enable GPs to prepare their year-end accounts.

In an exclusive interview with Pulse, Dr Geddes, a GP in York, also hinted that QOF could continue to shrink in future years in order to free up cash for CCGs to use for local commissioning priorities.

Throughout this year Pulse has reported a string of issues with GPs receiving late or incomprehensible payments from CCGs, local area teams and other agencies.

Some practices have been threatened with court summons to take their properties away, and Pulse revealed last month that almost half of GPs in England were still facing unresolved issues with late or incomplete payments, a situation that GP leaders said was ‘unacceptable’.

Dr Geddes said some of the problems were ‘inevitable’ due to the complexity of the handover from PCTs, but insisted the problems would be sorted out before the next financial year at the latest.

He said: ‘We are not just trying to spend a lot of time just doing a process map. We are looking at solutions as we go along, and some solutions have already been found. So it is a matter of getting a solution, delivering it and moving on.’

‘The issue for us is to make sure that there is confidence in the system and really importantly for practices, that actually they need to audit, particularly at times of uncertainty, what are the payments for? So therefore it is really important that we have a system that can give practices up-to-date information regarding the audit trail that is required, so that they are going to be able to do their year-end accounts.’

When pressed by Pulse if he could give a ‘cast iron’ promise that it would be fixed before April, Dr Geddes said: ‘Oh, yes. It should be before then.’

Dr Geddes also suggested that plans to shrink the QOF this year could be the beginning of a programme of changes to reduce the influence of the framework in future years.

He said that there would be some ‘national requirements’ retained in the QOF, but that NHS England was looking at how it could free up funds for CCGs to commission practices to address local priorities.

He said: ‘The purpose behind shifting QOF is to rebalance the work that we are asking GPs to do and taking the process away from bureaucracy and moving it to more meaningful clinical engagement, and that is how we want to see the world developing.’

‘QOF has some advantages – there are some good elements of QOF – but what we do need to do is make sure that actually we are looking towards a future and engaging much more with CCGs about how we wish to be able to deliver a broader scope of care.’

‘That means that in the future we will find a far greater dialogue between CCGs and area teams about what the out-of-hospital offer should be for primary care.’

Dr Robert Morley, chair of the GPC contracts and regulation subcommittee and executive secretary of Birmingham LMC, said that as GPs have different year ends, it would not benefit many to have the problems resolved by April.

He said: ‘Different practices have different accounts, some practices I’m afraid may have accounts that finish at the end of the calendar year.’

He added: ‘The NHS is getting away very lightly with the horrendous problems it’s caused for practices, practices will have lost money, will have had to incur lots of additional managerial work in trying to chase these payments. They’re not going to be compensated for that in any way.

‘So fair enough to say they’re going to sort things out by the end of the year, but tnat will have taken 12 months to sort out a complete and utter mess of their making, and it won’t compensate for anything thats gone wrong in the intervening 12 months.’