Exclusive NHS managers have told practices they will have to pay for the removal of their trade waste as NHS England cuts down on discretionary payments.
The removal of trade waste had traditionally been paid by most PCTs, but local area teams in areas where practices were reimbursed have begun withdrawing the payments.
Merseyside local area team sent a letter to practices stating it will withdraw payments, which it told Pulse was in line with the policy across local area teams.
GP leaders said that this ‘not inconsiderable’ expense was being withdrawn across the country, and criticised NHS England for putting more financial pressure on practices.
The GPC is currently in the middle of negotiating changes to the premises costs directions, which states what are discretionary payments.
PCTs had traditionally paid costs for the removal of trade waste, but some PCTs – such as Derbyshire – had started withdrawing the payments before their abolition.
The letter from the Merseyside local area team to practices said: ‘I am writing to advise you that with effect from 1 April 2014, NHS England will no longer fund Commercial or Trade waste services for practices.’
‘The Premises Directions 2013, Part 3, paragraph 46 (1) (b) lists the payments NHS England has a duty to make, this excludes the collection and disposal of Commercial/Trade waste.’
A statement from the area team sent to Pulse said this was consistent with the approach across England.
It said: ‘In other parts of country LMCs have supported negotiation with trade waste companies to arrange cheaper cost for practices in light of the Premises Directions. The action taken by the Merseyside Area Team is consistent with other Area Teams.’
GP leaders said this was an issue across England.
Dr Bob Morley, chair of the GPC contracts and regulations subcommittee, said: ‘Different PCTs had different arrangements. There is an obligation under the regulations to reimburse disposing clinical waste, but that doesn’t apply to trade waste.’
‘I am aware that historically some PCTs were reimbursing it, it was on a discretionary basis so it is hardly surprising that NHS England nationally are cutting down on anything they consider to be a discretionary payment.’
‘It is yet another expense that was historically being provided to practices.’
Dr Rob Barnett, chair of Liverpool LMC, said that Merseyside had continued to reimburse while others withdraw the funding.
He said: ‘It could be argued that we have been lucky where we are, that we have been getting that reimbursed.’
‘My understanding is that this is not a local issue, it is a national issue. The only way it will get resolved is by getting the premises cost direction reworded.’
Dr Ivan Camphor, medical secretary at Mid Mersey LMC, said: ‘It’s not an insignificant amount of money. It will be considerably amount of money that they will have to budget for again.’
‘With underinvestment and no sign of any recovery, it seems absolutely disastrous that people want to remove any more investment from practices.’
Dr David Geddes, Head of Primary Care Commissioning at NHS England, said: ‘We are aware that many PCTs and subsequently area teams have reviewed the arrangements for paying trade waste and a number have now taken the decision to no longer offer reimbursements as a result of competing priorities for primary care resource. We will pick up the implications of this within our discussions with the GPC.’
This is not the first discretionary service being cut by NHS England, which has already said it will stop funding GP occupational health services unless there are performance issues. GPs have also complained of withdrawn payments for maternity and paternity locum cover, as NHS England was reviewing all payments.
Please note: story incorporated Dr David Geddes quote at 11:23 on 25/02/14