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GPs face pay delays as PCTs outsource to India

Exclusive GPs have been beset by a ‘catalogue of problems' in paying practices and ‘unacceptable administrative errors' after PCT back-office functions were outsourced through a controversial joint venture between the Government and a private firm.

GPC leaders met last month with NHS Shared Business Services – run jointly by the Department of Health and private company Steria – following a series of complaints from GPs, including over errors in processing work outsourced to India and confidential patient information sent to the wrong PCT.

LMCs in the East Midlands and across London have reported delays in registering patients and delivering capitation payments to practices, errors in

reimbursing practices for registrars, mistakes with transferring patient records and inappropriately managed list validation.

GPC chair Dr Laurence Buckman said negotiators had acted after subcontracting of services had left practices ‘very adversely affected' by delays to payments without knowing who to chase up: ‘GPs are being hit by the way it is being done. They used to be able to call the PCT to address problems, but now they have to phone someone they have no relationship with – bits of it are outsourced abroad.'

NHS Shared Business Services said it had met more than 99% of its service level agreements and dealt with ‘early issues' in a ‘timely and efficient manner'.

The organisation said it had been ‘pleased' to meet with GP representatives: ‘There were concerns around some specific areas of the service. We are dealing with these. We will review operational procedures and make changes where necessary.'

Chris Locke, chief executive of Nottinghamshire LMC, said practices had experienced a ‘catalogue of problems': ‘The biggest issue has been GP registrar pay – practices have not been reimbursed properly. There have also been delays in patient registration and payments ending up in the wrong bank accounts.'

Dr Greg Place, chair of Nottinghamshire LMC, said: ‘We've had rather slow financial [transfers]. They are not being very quick with note transfer either. There has been quite a lot of disquiet.'

The LMC has also raised the alarm over an ‘unacceptable error rate following processing work being undertaken in India', while NHS Derby City reported a ‘serious incident' after patient-identifiable information was sent to the wrong PCT.

NHS East Midlands said NHS Shared Business Services was working ‘directly with PCTs' to address the issues.

In London, problems include the list-cleansing drive in Brent, first revealed by Pulse in March, which saw 38,000 patients stripped from practice lists. GPs in Tower Hamlets have also complained about the transfer of patient notes.

Dr Michelle Drage, chief executive of Londonwide LMCs, said: ‘This isn't just about GPs having delays in payments – the problems can have an impact on patient wellbeing as well.' 

A DH spokesperson said a framework awarded to NHS Shared Business Services in 2004 allows the venture to be handed contracts without competitive tendering until the framework expires next March.

NHS Shared Business Services provides back-office support for 46 PCTs and nine SHAs. But North Essex LMC has successfully campaigned against the venture taking on services, and LMCs across the South West hope to block a proposal for the venture to run administration of family health services.

Dr Philip Fielding, chair of Gloucestershire LMC, said: ‘We're questioning whether we have seen the full business case. We have a good service already. '