Exclusive GP practices are reporting the 1 April transfer of responsibility has caused ‘chaos’ with payments that used to come from PCTs, resulting in severe cashflow problems.
Practice managers have complained of irregular payments and problems claiming for business rates and water bills, while elsewhere GPs have identified issues with PMS payments and DES reimbursement.
NHS England told Pulse that its local area teams were experiencing some ‘transitional’ problems with payments, but said it was working to sort out the issues ‘as soon as possible’.
GPs were warned to make contingency plans to protect their cashflow earlier this month, with LMC leaders warning that many of the local area teams handed responsibility for GP contracts were facing ‘huge problems’ and lacked the capacity to carry out their job effectively.
This warning looks to have been prescient in some areas of the country, with practices in London and Manchester among those to report problems.
Posting on Twitter, south London GP Dr Rosemary Leonard said: ‘Payments to GP practices in Lambeth chaotic post 1 April. Totally unacceptable - many GP and staff will get no pay at all.’
Dr Leonard was not available for comment, but one practice manager in Lambeth, who did not wish to be identified, said the problems locally related to PMS contract payments from the local area team.
She said: ‘It is in regards to the PMS payments and how we are being paid now. It’s now in drips and drabs, whereas we used to get one payment per month on a specific day of the month and everything was lumped into that payment. We knew it was all in there and you just divided it out.’
‘Now it’s so-and-so will pay this bit, and so-and-so will pay that bit, but no one knows when you’re going to get paid for that, who by, and it is still not very clear who is doing what.’
Another practice manager in Havering, who also wished to remain anonymous, complained of a lack of arrangements for paying business rates and water bills.
She said: ‘The bills are due by the end of the month and it is causing cashflow problems.’
A spokesperson for Havering CCG said: ‘The responsibility for primary care now rests with NHS England and the CCG has already met with their representatives to discuss issues such as this on behalf of our membership. We expect this issue to be resolved very soon.’
Dr John Hughes, honorary secretary of Manchester LMC and a GP in Crumpsall, Manchester, said a separate PMS problem locally had now been resolved, but added that he was also concerned about enhanced service payments.
‘There was a problem with PMS payments in the middle of April. Practices were due to be paid on the 15th but were paid on the 16th. The area team here in Manchester sent out a warning about that, so that was not a major issue.’
‘What does seem to be of a bit more concern is some of the LES and DES payments which were previously paid by the PCT. It doesn’t appear to be exactly clear who actually authorises those. So there is some concern that for the end of the month, and end of the quarter, that might cause cashflow problems.’
GPC negotiator Dr Chaand Nagpaul said: ”The main problem we are finding is that because of the changes from PCTs to local area teams some payments have not been made. My own practice was not paid for a DES from last year, for whatever reason.’
‘It may just be a delayed payment but this incurs time that practices have to spend to try to rectify the problems. Trying to find the right person is difficult. Local area teams are more remote to GPs than PCTs were. There are going to be administrative hiccups and there are going to be issues with identifying the right person to solve the problems.’
However NHS England moved to reassure practices that it was working to resolve issues.
A spokesperson said: ‘We are obviously committed to ensuring that the right systems are in place to make payments. Where there have been transitional difficulties, these will be resolved as quickly as possible.’