By Alisdair Stirling, Gareth Iacobucci
Exclusive: GPs are set to inherit acute sector overspending of up to half a billion pounds and will have to grapple with widespread miscoding of hospital procedures, a Pulse investigation reveals.
Figures obtained under the Freedom of Information Act show that PCTs were on average expecting to end the last financial year nearly £3.7m over budget for hospital care, and extrapolation suggests the total acute overspend for England could be as high as £550m.
NHS Birmingham East and North reported an acute overspend of £15m, while NHS Swindon and NHS Mid Essex both said they faced acute deficits of £11m.
NHS Swindon said its acute overspend had been caused by overperformance in elective care and under-use of its independent sector treatment centre.
Our investigation also suggests that GPs face make-or-break talks with hospital chiefs over disputed payments – with almost half of the 42 PCTs responding accusing hospitals of overcharging for services by coding procedures incorrectly.
Bexley Care Trust is challenging a £4.6m bill from its acute trust, and said it had held talks to discuss changes to ‘counting and coding of activity’.
The findings come after Pulse revealed last month that the Department of Health is poised to add more levers into secondary care contracts to give GPs greater negotiating powers with hospitals.
Dr Charles Alessi, chair of the Kingston Commissioning Consortium in Surrey and executive member of the NAPC, said miscoding was ‘a real problem’.
‘The systems we have may not be as fit for purpose as we think they are,’ he said.
Dr Kailash Chand, chair of NHS Tameside and Glossop, said: ‘It’s not the failure of foundation trusts. It’s the system. You can’t have a supermarket ethos in healthcare.’
A DH spokesperson said acute overspending was not reflected in PCTs’ overall budgets: ‘At quarter three of 2010/11, SHAs and PCTs were forecasting an overall surplus of £1.3bn. We expect the final year-end position to be broadly similar.’
Miscoded hospital procedures are costing some PCTs millions of pounds