Exclusive NHS England has refused to pay a GP practice £20,000 of missed income from its flu vaccination campaign two years ago due to an ‘administrative error’.
GP partners at the Kingsfield Medical Centre in Birmingham noticed earlier this year that they had not been paid for participating in the flu campaign in 2021/22.
On raising this with NHS England, they were told that the practice had failed to send a signed declaration form, meaning that technically no contract was agreed to provide flu vaccines that year.
As such, NHS England has refused to make the retrospective payment, despite the practice’s consistent participation in the vaccination campaign every year.
The practice made an appeal to NHS Resolution, who supported NHS England’s decision.
One GP partner at the practice told Pulse that while the practice manager is sure the form was indeed sent to NHS England, the team is prepared to accept some fault as there is no email trail of this.
However, he said it ‘feels like a very hard judgement for an administrative error’, especially since the clinical work was ‘carried out appropriately and effectively’, and since practice has a ‘history of taking part in every flu campaign’ before and since.
The GP partner added: ‘We accept that we have made an error, but this has never happened before. We’ve always run a really good flu campaign, and we did run a good flu campaign that year – we can prove that we’ve vaccinated more than 2,000 patients in that particular campaign.
‘It’s pretty galling to have this response which feels clinical, cold, and punitive.’
He said the £20,000 is ‘very significant’ for the practice and could have been used on additional staff or resources, therefore positively impacting patient care.
The practice team feels that NHS England and NHS Resolution have focused on the technicality of the administrative error rather than the overall circumstances.
‘It’s a hit to the practice. It’s a hit to morale, and just doesn’t engender the most positive relationship between general practice and NHS England,’ the GP partner told Pulse.
The GP practice has also highlighted that if NHS England was aware of the omission in 2021/22, no efforts were made to encourage them to sign up for the flu campaign.
In NHS Resolution’s official decision, seen by Pulse, head of appeals Jonathan Haley wrote: ‘I am satisfied that the Commissioner can decline the request for payments for the period for the vaccinations given to its patient population for the 2021/22 financial year as the Contractor has not demonstrated that it submitted its DES agreement as required by the Enhanced Service Specification – Seasonal Influenza vaccination programme 2021/22 or the Enhanced Service – Childhood Seasonal Influenza Vaccination Programme 2021/22.’
Throughout the process, NHS England asserted it does not doubt that Kingsfield Medical Centre successfully administered flu vaccines to around 2,000 eligible patients during that period, but that the basis for the dispute is whether there is evidence the practice signed up in the first place.
NHS England also said the fact that the practice came forward with this information in March 2023, when their accountants noticed the missing payments, means any claim is beyond the policy window.
‘The Midlands Public Health Commissioning Team in NHS England has a clear and agreed policy that claims made outside of the 6-month contractual range will not be paid and therefore in order to be fair and transparent to all practices this policy is applied consistently,’ NHSE said.
NHS Resolution echoed NHS England’s belief that the practice ‘should have been aware sooner than the end of the next financial year that there was a problem with this DES’.
Birmingham LMC supported Kingsfield Medical Practice in this dispute, writing a letter which said NHSE’s initial decision was ‘completely unfair’.
The letter said: ‘We have based our supporting decision on information that has been supplied to us on behalf of the practice.
‘This included historical records clearly identifying the Practice as a high achiever in previous years in connection with the Influenza Vaccination Enhanced Service. In fact, the year 2021/2022 appeared to be their highest vaccination figure than any other year since the Enhanced Service inception.’
However, NHSE responded by saying that ‘historical performance has no bearing or relevance to this particular issue’.
The commissioner also highlighted that practices should have ‘robust systems’ in place to ensure more than just one individual is responsible for submitting financial documents.
NHS Resolution said ‘both parties were given opportunity to provide submissions’ to its Primary Care Appeals service ‘in line with our normal procedures’ and that the decision notice ‘sets out our reasoning’. It will further publish its its determination with full reasons on its website during week commencing 6 November.
NHS England declined to comment.
In August, the new enhanced service specification for this year’s 2023/24 flu vaccination campaign revealed that the time limit for submitting payment claims has been shortened from six months to three months.
And last month, the BMA’s GP Committee demanded an investigation into the Government and NHSE’s ‘mismanagement’ of this year’s vaccination programmes, claiming that communication were ‘muddled’ and that cuts to the Covid jab fee mean the campaigns will not be ‘financially viable’ for GP practices.