GP practices forced to repay up to £300k due to ICB admin error

An ICB’s administrative error has left several GP practices across Nottinghamshire facing clawbacks of up to £300,000.

For one struggling practice, the clawback was ‘one of the final straws’, with partners handing back their contract soon after the error came to light.

Nottingham and Nottinghamshire ICB has confirmed that discussions are ongoing with each practice regarding the ‘repayment of monies back to the ICB that were paid to them in error’. 

According to the LMC, when practices were moved from PMS to GMS contracts at different points over the last four years, the ICB failed to record their ‘opt-out’ from providing out-of-hours services.

This meant that 16 GP practices were wrongly paid for OOH work in their global sum payments, with payments ranging from around £20,000 to £300,000, as first reported by GP Online.

GP contractors who do provide OOH services are paid an extra 4.75% on top of their contract – those practices impacted by the error were paid this additional sum.

One of the practices affected, the Windmill Practice, handed back its contract in December, and earlier this month the ICB announced that the contract will switch from GMS to APMS.

Nottinghamshire LMC chief executive Michael Wright said the ICB’s clawback is not the only reason for this contract hand-back, but that the clawback requirement made the contract ‘less attractive’ to prospective independent contractors. 

He told Pulse the LMC is pushing for either a reduction in repayments or a write-off, where practices are really struggling, as ‘ultimately, it’s the ICB’s mistake’. 

‘Our argument really is that technically the ICB might be right [about repayment] but this money is still being spent on patient care and by demanding it back you’re just going to destabilise practices further.’

Mr Wright added: ‘I’d say [to the ICB]: look at the bigger picture, practices are in really, really difficult financial positions. They’ve used this money on public services. You’re saying it’s public money and you’ve got a responsibility to the public purse – but it has been used for the public. 

‘So I’d like to try and justify getting them at least an adjustment if not a complete write-off, if it’s going to really destabilise them, which in some cases it will.’

The ICB did not confirm any deadline for repaying the money, but Mr Wright understands that for most practices, commissioners want to receive repayment within two years. 

A spokesperson for the ICB said: ‘We are in discussions with specific individual GP practices in Nottingham and Nottinghamshire relating to the repayment of monies back to the ICB that were paid to them in error, for services which they did not provide. 

‘In all cases the situation arose following changes made in contractual status and the contract payment mechanism not being adjusted to reflect the change.’

They added: ‘We very much regret the impact that this may have had on practices operating as independent businesses. However, this is the public’s money and we have a duty to ensure it is allocated correctly. 

‘To minimise the impact on those affected practices, we are speaking with them on a one-to-one basis to agree the best way for them to repay over an agreed period.’

In October, practices were contacted about GP seniority calculations dating back 10 years meaning some could be asked to repay thousands of pounds. 

Pulse reported last year on a GP practice in Birmingham that was denied £20k of missed income from its flu vaccination campaign two years ago due to an ‘administrative error’. 

Correction: This article was updated at 11.00 on 12 March to remove a claim that Primary Care Support England (PCSE), run by Capita, was responsible for the initial administrative error. Capita has clarified that ICBs are responsible for updating a practice’s optional services in their online portal.