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Practices forced to take out overdrafts following late payments

GPs have come to ‘the end of their tether’ as partners are forced to take out overdrafts following delayed payments from NHS England, CCGs and other agencies, the GPC has warned.

Dr Ian Hume, chair of the GPC’s Practice Finance subcommittee told Pulse that the GPC was continuing to have ‘high level discussions’ with the Department of Health, after practices continue to have their cash-flow disrupted by late payments.

LMCs report that payment problems continue despite NHS England promising to speed up and improve their financial systems.

Pulse has previously reported that GPs across England were having to delay paying essential bills as a result of persistent problems with NHS England’s book-keeping. Some practices suffering late payments were issued with court summons threatening to take the GPs’ properties away.

Dr Hume said the problems were still occuring and that some practices were forced to take out overdrafts to manage cashflow when payments were late, while at his own practice there was a delay in the practice receiving drug and dispensing payments worth £50k to £60k, he said.

Dr Hume said: ‘We are having high level discussions there. The profession has come to the end of its tether.  For practices, if you don’t get a payment, it’s personal. Its personal income you don’t see in your bank account.

‘It’s different if you’re salaried and you have it paid in and then you can sort out the problems later. I’m aware of practices taking out overdrafts and it costing them quite a lot of money because of late payment.’

He added that the problems were also from confusion by the array of different ‘pay masters’ introduced in April in England.

He said: ‘It’s not until the money doesn’t arrive in the bank that you realise you have a problem. For a small practice, that can be a significant problem. We still have a responsibility to pay our bills, to pay our providers, to pay our staff. As profit sharing partners, we get what’s left at the end. If you haven’t got the money coming in, it’s not a lot.’

Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire and Oxfordshire LMC said problems with indecipherable payments in his area was driving practice managers ‘to destruction’.

He said: ‘The moans are universal. We’ve heard rumours of overdrafts taken out. It’s certainly an ongoing problem. The more difficult problem is being able to track whether you’ve been paid the right amount.

‘The payments don’t come with anything to tell you what they are for so you can’t reconcile payments with the work done.

‘We’ve got three different sources of commissioners; public health, CCGs and area teams. All their payments come in little bits. It’s a major problem. It’s driving practice managers to destruction.’

Dr Rob Barnett, medical secretary of Liverpool LMC echoed those concerns.

He said: ‘Whole payment system is a complete and utter shambles. I accept it might be an unfortunate side effect of the re-structuring, but the brains who are in existence at the DH should have realised it was going to be a nightmare. The net effect will undoubtedly increase bank charges and accountancy costs.

‘Practices still owe for their mortgages. My bank manager, understanding though he is, does not care about the problems of the NHS’s payment systems. I have no confidence in the system.’

NHS England said it was aware there were issues with late payments, and that they are currently reviewing the payment process in order to come up with solutions.

Dr David Geddes, head of primary care commissioning at NHS England said: ‘We are aware of the issues that practices have been experiencing with their payments and we are working with our Area Teams and partners, including Local Medical Committees and the General Practitioners’ Committee, to resolve these issues.

‘There are, as Dr Hume has stated, issues that have arisen because GP services are being commissioned from a number of commissioners, with payments being channelled through one route. We are reviewing the payment process and will implement actions to resolve any underlying issues and improve payment systems. 

‘The GPC have been very helpful in supporting this piece of work, and we hope we can put solutions in place as quickly as possible. If a practice is experiencing extreme difficulties, I would urge them to make contact with their head of primary care at the area team.’