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NHS England launches investigation into missing DES payments



Exclusive NHS England is ‘urgently investigating’ issues that have seen GP practices around the country underpaid by thousands for the Avoiding Unplanned Admissions DES.

The stance marks a change from earlier in the week, when NHS England claimed that GPs who said they were missing thousands of pounds had ‘misinterpreted’ the DES requirements.

A spokesperson told Pulse that NHS England is ‘investigating [the problems] as a matter of urgency’ and would have more details soon.

Payments for the DES have been hit by a myriad of problems, with IT systems not logging care planspractices having to manually enter records of patient deaths and CQRS failing to collect data on achievement.

Since Pulse reported the issues with the DES payments – with the GPC claiming practices were losing up to £1 per registered patient – a number of GP practices in different parts of the country have come forward with reports of new issues.

A GP in Sussex said that the systems ignore care plan reviews prior to March 2015, meaning that even reviews ‘in the last 12 months’ were ignored.

A GP in Buckinghamshire told Pulse that a local investigation concluded that NHS England had failed to update guidance on which Read codes should be used.

NHS England told Pulse it was investigating a range of problems in cooperation with the Health and Social Care Information Centre, which is responsible for updating IT system providers based on information supplied by NHS England.

An HSCIC spokesperson said it was working with area teams and IT suppliers to address ‘unconfirmed reports’ of practices missing achievement targets against their expectations, and that it was advising practices to approach their area teams for local solutions.

But GPC deputy chair Dr Richard Vautrey said the missing payments was a ‘general issue’ happening ‘quite widely’.

He said: ‘We have made very strong representation to senior people within NHS England that they have to sort this out.’

One practice in the east of England told Pulse that it was missing £10,000 in funding, with its report showing it had apparently registered zero patients who were most likely to have an unplanned admission, despite having in fact registered the 2% of its list as required by the DES.

GPC negotiator and Essex LMC chair Dr Brian Balmer said his LMC had made a request to the area team to pay practices based on their own records of their achievement, to prevent serious cash flow issues, but this was blocked by NHS England in the absence of a national solution.

He said: ‘We asked them to make the payment based on practice’s accounts [but] NHS England said we should not agree local actions ahead of a national solution. So because of this national instruction, the [area team] has completely thrown out our suggestion.’

Meanwhile, GPs in London were advised that they could ‘send NHS England a screen shot of their clinical system’ to prove their record of their achievement.