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GP practice ‘owed £100k’ since NHS England overhauled payments system

Exclusive A 7,600-patient practice is claiming to have been left without £100,000 in assorted payments this year because of upheaval since NHS England scrapped local payment offices for a national system.

The Village Practice in Islington, North London, is missing rent, pensions and seniority payments, as well as immunisation reimbursements amounting to a six-figure sum, it has told Pulse.

Practice manager Amanda Meehan said she began raising concerns with NHS England and Primary Care Support England (PCSE), the GP support service function provided by Capita, in October.

Capita told Pulse that it had ‘clearly communicated’ all the new arrangements for payments to practices, but delays had arisen where these were not followed.

Ms Meehan said she was unaware of any warning, and told Pulse that the first she knew about the changes was when the practice’s monthly rent reimbursements stopped being made, followed by changes to timings of several other regular payments.

She said: ‘Together with the non-payments it was crippling. To give you some idea, we are owed £100,000 in missed payments. I’ve logged complaints, nobody responds. It doesn’t do anything.’

The practice claims that outstanding payments include:

  • Rent and premises reimbursements not paid in 2016/17 – £65,000

Which Capita told the practice ‘will need to be sent directly to NHS England’, though Ms Meehan said invoices last year, resubmitted in January, are still unpaid and NHS England had directed them to Capita.

  • Seniority adjustments from 2015/16 – £8,000 (As reported to Capita in November 2016)

Which Capita said ‘was paid over to the practice in January 2017’ but which the practice has previously told them ‘the payment was not right’.

  • Pensions refund – £7,275 (as of November 2016)

The Capita pensions team have asked for ‘further details’ before they can process this but, again, Ms Meehan says she has submitted the earnings reports three times already.

  • Child immunisations reimbursements (Agreed in writing with the local support services office prior to its closure) – £11,000

Capita explained they ‘no longer calculate adjustments for childhood imms’ and any late claims would be made at ‘NHS England’s discretion’. But the practice already has a written agreement with the previous local support services office which has not been honoured.

Ms Meehan told Pulse: ‘I know about ten practices in Islington who are all missing seniority, pensions, all the same things. And we are among the most deprived areas in the country.

‘To leave us without this kind of money is unforgivable. But to palm us off like this, what kind of small business can operate without this kind of funding?’

Pulse has seen emails between the practice and NHS England’s London office which show both parties have repeatedly escalated complaints to PCSE.

In one email, an NHS England (London) finance manager says it ‘is not in our interest to destabilise a practice financially’ but asks the Village Practice to be patient with the delays as the regional team only recently found out it would have a role in processing some of these payments following ‘late advice from Capita’.

A Capita spokesperson told Pulse: ‘Under the previous arrangement, local support offices were responsible for a number of payment processes which were not transferred to Capita.’

‘We and NHS England have clearly communicated the changes and new arrangements to practices. We are working with the practice to resolve the issues that we are responsible for and supporting them to resolve any areas that are now the responsibility of NHS regional teams.’

NHS England did not resond to a request for comment.

Support services disruption

NHS England’s own review of the first seven months of the Capita contract found that hundreds of practices had missed payments.

And these cases occurred before Capita began overhauling services, with many practices contending with significant disruption to payments, pensions, supplies and patient notes since March last year.

At the end of last year, the GPC warned that the service was still a ‘chaotic mess’ but practices have yet to be compensated for the disruption and additional workload they have suffered.

Last month, NHS England pledged that ‘significant improvements’ to general practice support services will be completed by April, as it seeks to return the services it outsourced last year to ‘acceptable’ levels.

But by then practices will have endured more than year of disruption, after Capita took over as NHS England’s national provider of primary care support in September 2015.

The move followed an NHS England cost-cutting drive where it slashed its £100m-a-year support services budget by 40% and has resulted in huge backlogs of patient records movement, delays registering new GPs and missed payments.

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