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GPs hit with massive bills after ‘inconsistencies’ found in out-of-hours deductions

Exclusive Hundreds of practices have been warned that their deductions for opting out of out-of-hours provision will be reviewed, with one practice facing a £19k bill to be paid in the next 12 months, Pulse can reveal.

NHS managers have admitted that due to ‘inconsistences’ in the way PCTs applied the rules on opting out of out-of-hours provision – agreed in the 2004 GP contract – they may face under- or over-payments.

NHS England’s London area team has sent out letters to 388 practices to inform them that they were reviewing all GP contributions for providing out of hours services after ‘differing approaches’ by PCTs led to practices being paid inconsistently.

One letter, seen by Pulse, and sent this week, told a practice it had to make a make a payment of £18,700 over the following 12 months.

But LMC leaders have questioned the methodology used to identify the inconsistencies and have rejected claims that the move had been agreed with the LMC.

The local area team said that it was only clawing back overpayments over the past financial year after inheriting the payment systems from PCTs, and some practices will receive money back for underpayments too.

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The letter to one practice, seen by Pulse, said: ‘NHS England is in the process of reviewing all primary care contractors’ contributions for providing out of hours services.’

‘This review will ensure that there is an equitable methodology in deduction across all practices across London going forward, and that GP practices aren’t being over, or under charged.’

‘Previously, each borough was using a different methodology to calculate the deductions and this will standardise the approach across London.’

It added: ‘In your case the difference is £-18,700.97. If this figure is negative you owe money to NHS England and if it is positive NHS England owes you money.’

A spokesperson for NHS London local area team said: ‘In line with the issued guidance and a single operating model approach, NHS England London region has written to its contractors advising them of the correct level of deduction for their decision to opt out of OOH provision. While these inconsistencies have existed for a number of years, the revised levels of deduction will be only be implemented from the 1 April 2013.’

However, the LMC leaders questioned the methodology. Dr Tony Grewal, medical secretary of Londonwide LMCs, said: ‘We have not seen the calculations that NHS England have made to compare with the calculations that PCTs have made, so we are looking for clarification on that.’

The NHS England letter claimed that the methodology ‘was discussed and approved by the LMC in October 2013’. But the LMC rejected these claims. In an email to members, it said: ‘The methodology was not discussed and agreed with the LMC in October 2013, as is stated in the NHS England letter.’