GP practices facing £6m clawback from ICB may have to close, leaders warn

Exclusive GP practices in one area could be forced to close due to the local ICB intending to claw back £5.7m of funding it ‘paid in error’ over a number of years, Pulse has been told.  

Wakefield LMC told Pulse that it is currently in the process of obtaining advice on whether it can launch a legal challenge against West Yorkshire ICB, over its intention to claw back millions of pounds of out-of-hours deductions it failed to take from 28 practices.

The LMC raised concerns over the serious impact that the clawback will have on practices, warning that many would be destabilised and at risk of closing, and it stressed the effect this will have on patients.

The clawback would affect all PMS practices in the area, to which the ICB is supposed to apply a deduction for opting out of providing out-of-hours services.

The ICB told Pulse that it ‘regrets any impact this may have on practices’ but ‘must take into account that these are public funds intended for NHS services’ and ‘paid in error for a service that has not been provided’.

LMC medical secretary Dr Carolyn Hall said: ‘The ICB had not been taking the out-of-hours deductions from PMS practices, which no one was aware of, and we don’t know how long this goes back to.

‘A year ago, they said that they were going to start taking them, but at that time there was no intention to retrospectively ask for money from previous years, so we’ve been paying for a year. Then in April this year they said that they were going to claw back previous years’ payments.’  

She said that the total claw back would be £6m, with practices paying back hundreds of thousands of pounds to the ICB over the next three to six years.

Dr Hall told Pulse: ‘The assumption from their point of view is that this all went into GPs’ pockets, which it didn’t, it’s been used for patient care.

‘Our point of view is that it wasn’t our error, we weren’t aware of it, and they produced no clear evidence of what happened or why.

‘We are also really concerned about the impact on patient care, because this is the sort of amount of money that is going to cause practices losing doctors and nurses.

‘It may destabilise practices, especially if they have things like NHS Property Services debts to deal with. The other significant thing is that if any of the practices close because of this, there aren’t enough GMS practices to pick up the workload because there’s only six in the whole of Wakefield. The main thing that we want to stress is the impact on patient care.’

Last month the LMC formally wrote to the ICB on behalf of practices, setting out a series of questions about how these decisions were reached and requesting further background information.

The ICB agreed to take no further action while the LMC obtains legal advice, and confirmed that ‘no assumption is made as to liability whilst the matter is under legal review’.

Dr Hall added: ‘At the moment we are trying to get legal opinion to see if we can get a legal challenge – obviously if that says no, we will individually talk to the ICB as practices about why this is going to cause problems, we will also talk to patients and to local MPs. The ICB could choose not to do this.’

The ICB said that a ‘dispute resolution procedure’ is in place to ensure that the matter is ‘resolved efficiently’ and ‘fairly’.

A spokesperson for the ICB told Pulse: ‘NHS West Yorkshire ICB in Wakefield District is in discussions with 28 GP practices and Wakefield LMC in relation to overpayments made in error for out-of-hours services where these services were not provided. The amount the ICB is seeking to recover is £5.69m across all affected practices. 

‘The ICB regrets any impact this may have on practices but must take into account that these are public funds, intended for NHS services, and paid in error for a service that has not been provided.

‘The ICB is speaking with practices individually about repayment and will offer the option of repaying the monies over an agreed period to help reduce the impact on practice budgets.

‘A dispute resolution procedure is in place, which the ICB is committed to following, to ensure that the matter is resolved efficiently, fairly, and taking into account any representations made by the practices. This includes the option for determination by an independent adjudicator, should the ICB and any practice be unable to resolve the dispute locally.’

In 2024, the same error around out-of-hours left several GP practices across Nottinghamshire facing clawbacks of up to £300,000, with partners at one practice handing back their contract soon after the error came to light.