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Missing unplanned admissions DES payments could be delayed into New Year

GP practices could go into the new year missing thousands of pounds in payments, due by mid-November, for work completed for the Avoiding Unplanned Admissions DES.

NHS England has given no update on when practices can expect payments or what is causing the delays, though it did say it would ensure ‘no practice is left out of pocket’ for work they have undertaken.

Pulse first revealed the payments had been delayed in November, and NHS England initially dismissed practices’ concerns blaming GPs’ ‘misinterpreting’ the specification of the DES despite a range of errors being pointed out.

When the problems persisted NHS England was forced to investigate, and two weeks ago told Pulse it was ‘urgently investigating’ a range of errors.

With some practices more than £10,000 out of pocket the GPC has called for local flexibilities to empower CCGs and area teams to step in. However, in a letter seen by Pulse, NHS England’s East of England regional team wrote to Essex LMC explaining they had been asked to refrain from making any payments.

The letter said: ’We have been advised by the NHS England national team and CQRS, following a teleconference with all parties, that we should not amend data or make payment declarations until CQRS complete their investigations.

’We are sorry for the inconvenience that these issues continue to cause but having received this definitive advice we are not able to make any local adjustments at this time.’

The letter further summarised the problems identified with payments by NHS England and IT system suppliers as:

  • Both SystmOne and Emis Web passed the certification for data extraction for this enhanced service but when the extraction took place on live systems the figures produced were not correct. These extractions have been corrected and re run but not all practices that expected to produce a figure did so.
  • Some practices returning “0” as the Avoiding unplanned admissions register.
  • Some practices reporting that they have not manually entered a figure for their dead and departed figure and that it has been pre-populated.
  • The figure in the box for the dead and departed is higher than the actual register.
  • Practices reporting that their register size is inaccurate. In some instances practices have been able to identify coding issues to understand this but this is not always the case.
  • Concerns around the ambiguity between the Enhanced Service Specification, the guidance documentation for this service and the business rules.

GPC deputy chair Dr Richard Vautrey said: ‘We’re continuing to push NHS England to sort this out and to do so quickly. NHS England and CCGs as commissioners should act reasonably and have the necessary flexibilities to resolve this and recognise that practices have in good faith done the necessary work.’

An NHS England spokesperson said: ‘We are aware that some practices have been experiencing issues with their avoiding unplanned admissions payments. We have asked the Health and Social Care Information Centre to work with GPs and NHS England to identify a solution, and will ensure no practice ends up out-of-pocket as a result.’

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