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GPs given second chance to meet unplanned admissions deadlines

Exclusive Over 150 GP practices in the south of England were being given a second chance to meet the deadline for reporting on the Avoiding Unplanned Admissions DES, in spite of central NHS England advice to give no leniency.

NHS England’s area teams in the south all said that as yet, no practices are set to miss out on payment, despite more than 150 practices missing the 30 September reporting deadline because IT delays meant practices had to manually enter the information into the CQRS.

But this was in direct contrast to previous NHS England guidance, which said that no leniency should be given, leading to concerns from GPC that there is patchy implementation across the country.

Pulse asked area teams across the country how many practices had missed deadlines, and whether they were punishing practices for doing so. Local area teams in the North, Midlands and East of England refused to answer the request, but area teams in south of England revealed:

  • 31% of GPs in the Thames Valley area missed the reporting deadline;
  • 18% in Devon, Cornwall and Isles of Scilly and 15% in Bath, Gloucestershire, Swindon and Wiltshire missed the deadline;
  • in Surrey and Sussex just 3% missed the reporting deadline;
  • in Wessex not a single practice missed the deadline despite all 312 practices being signed up to do the DES;
  • the Bristol. North Somerset, Somerset and south Gloucestershire local area team said it was ‘awaiting a large number of CQRS submissions

In all, NHS England’s area teams in the south saw 97% sign up to the DES.

Kent and Medway area team said it has delegated the DES management to the CCG and will, in the meantime, pay all practices. Those found in an end-of-year report to have missed the deadline will face the money being clawed back.

In total, at least 152 practices missed the deadline, although close to half (73) of those are in Thames Valley.

In addition, area teams also highlighted four instances where practices may not end up getting paid because it appeared they had not delivered the DES to its specifications.

However, there had been fears that this total would be much higher following a letter to area teams in July this year in which NHS England said that it was important that regulations are applied to the letter because the DES will ‘undoubtedly be scrutinised’ as it contains such a large tranche of funding.

The head of primary care policy, Deborah Jaines, wrote: ‘As I am sure you will appreciate, at a national level, a significant amount of funding is associated with this scheme and all elements were carefully agreed with the Government and negotiated with the GPC. As such, the uptake and performance against this service will be undoubtedly be scrutinised. So it is especially important that all area teams are applying the same rules for funding.’

GPC chair Dr Chaand Nagpaul said: ‘We know that this DES has been extremely hard work and that general practice has been under huge strain. Given this, I think that area teams should be able to exercise flexibility to relax timescales. It is encouraging that many area teams have done so, but we believe that this should be consistently applied across the country.’

It comes as the GPC has negotiated for the reporting requirements under the DES to be significantly reduced in 2015/16, with Dr Nagpaul adding: ‘It would make sense for area teams to wish to implement the philosophy of what has been negotiated for next year this year, rather than actually making this be about bureaucracy.’

A spokesperson for NHS England (South) said: ‘This is a snapshot of a particular moment in time – we are not looking to withdraw payment at this stage – we are still giving practices the opportunity to submit their report.’