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Flu vaccine payments delayed leaving practices out of pocket over Christmas

Exclusive: GPs are being denied timely payments for administering the flu vaccine jab due to further problems with the payments system that practices have been wrestling with since April, Pulse has learned.

LMCs had to inform NHS England local area teams that practices were missing out on thousands of pounds earned for the seasonal influenza DES because of a logging issue in the CQRS payment system that had gone undetected since October.

Although the area teams are taking steps to make the payments, practices have been left out of pocket for money they were expecting over the Christmas period.

Family Doctor Association chair Dr Peter Swinyard, who is a GP in Swindon, said this was a significant problem to his practice, which had outstanding payments pending since November.

He said: ‘The problem is of delayed payment. We were expecting payment at the end of last month but now they will instead be coming in dribs and drabs over the next two months.

‘It is part of the payment problems with NHS England, they don’t seem to be able to sort themselves out at all.’

Derby and Derbyshire LMC secretary Dr John Grenville said he was aware that the problem had affected a number of area teams, including in the Nottingham and Derby area.

He said: ‘It appears that there are problems with the CQRS system across several area teams and a number of practices who thought they had submitted claims via CQRS have not been paid. I understand it has taken all this time – we are talking about October payments – for the IT people to discover that there is a problem, and now that they are recognising that there is a problem two things are happening. One, we think the area teams are looking at ways to make the payments anyway, and two I assume the IT guys are attempting to solve the problem.

‘Practices hadn’t known what the problem was and had complained to us at the LMC, so we raised the problem with the area team and heard this week that the problem had been identified. It would have affected anything that should have been paid for through CQRS but the flu DES would have been the big one.’

He said that the October payments were ‘well out of date’, but added that they would have been fairly small as people were only just getting started with flu vaccinations.

However, he added, ‘for November we certainly hope that the full payment will be made because that will be the middle of the flu season and people will have been putting in fair-sized claims’.

This could be in the region of thousands of pounds for a practice, he added: ‘It is difficult to say, but for a medium-sized practice I think we are talking a few hundred pounds on the October payment and maybe £2,000-£3,000 for the November payment.’

As reported by Pulse, GP practices have been suffering severe and continuing cash flow problems since NHS England took over the day-to-day running of primary care commissioning from April, including receiving incorrect, late and unidentifiable payments.

NHS England was unavailable for comment on the issue of payments for flu vaccinations.

It comes as NHS England said it was in the process of informing practices that it resolved the ussue of unidentifiable payments appearing on their bank statements – a problem it had promised to sort out by the end of last month.

A spokesperson said: ‘Improvements have been made to practice statements generated by the National Health Application and Infrastructure Services (NHAIS) system which were rolled out in November.

‘When an NHAIS payment is authorised, an email is sent to those that subscribe to Open Exeter (OE) to advise them their statements are available to view on OE. This email communication was recently changed to reflect the availability of the new NHS England/CCG statements, so those GP practices who subscribe will already have been emailed about the new remittance advice. NHS England and the BMA are working together on issuing guidance and communications to practices to publicise this change, and this will be finalised very shortly.’

However, Dr Andrew Sant, a GP and medical director at Plymouth Community Healthcare, a business part-funded by an APMS contract, said unidentifiable payments remained an issue.

He said: ‘Certainly our monthly statements remain incomprehensible as to what we have been paid. Our APMS contract is worth around £1.7m per annum out of a total turnover of £85m but it gives our finance department significant problems in cash flow and position forecasting.’

Dr Grenville said: ‘Our area team has been fairly responsive about [unidenfiable statements] and have in fact now said that all lines on the payment will be identifiable and if there are…new types of payments added they will send out basically a key so that people will know what the abbreviation stands for.’