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Practices forced to fight for overdue LES payments

Exclusive: A vacuum in PCT management caused by an exodus of staff is forcing practices to chase thousands of pounds in overdue enhanced services payments, with some being forced to consider legal action to recoup money owed.

A Pulse survey of 252 GPs has found as many as one in eight practices is owed LES funding, with many submitting formal appeals to reclaim the money, and some even taking legal action.

It comes as LMCs claimed the transition to CCGs had led to administrative ‘chaos’ in PCTs, with one even claiming a key manager had ‘disappeared’.

Some 13% of GPs surveyed said they were owed LES payments from their PCT, with 7% having made a formal appeal to reclaim the money, and a similar proportion considering, planning or taking legal action.

Legal experts estimated there had been a 50% rise in GP appeals for LES monies owed by PCTs in the first six months of 2012/13 compared with the same period last year, while medical accountants said up to one in four practices was appealing over unpaid LES or QOF funding.

Andrew Lockhart-Mirams, senior partner at Lockharts Solicitors, said sums of up to £30,000 were being disputed, but most were between £3,000 and £8,000. ‘For practices this is the difference between bread and butter, and bread, butter and jam,’ he said.

Bob Senior, head of medical services at RSM Tenon, said: ‘We see more of this now than in previous years; I would say it now affects about 20-25% of practices. In these tough economic times even £5,000-£10,000 is a lot.’

Dr Tony Grewal, medical director of Londonwide LMCs, said London PCT clusters were in administrative ‘chaos,’ citing one case where an administrator responsible for making LES payments was not replaced, forcing practices to wait three months for their money, and cover costs out of their own pockets.

He said: ‘In some cases, they were owed thousands. As a GP, you are left with the options to either sack staff or reduce your drawings.’

He said the LMC was also dealing with a case where a cluster official who had signed off a LES had apparently disappeared, with not even the head of the cluster able to track them down: ‘We are trying desperately to keep a handle on responsible staff but are finding that someone is there one week, then has disappeared the next week.’

A spokesperson for NHS London said: ‘We are working with GPs to make sure all systems are in place to smoothly manage the transition. We are concerned to hear about this and would urge the practice to speak to their local PCT in the first instance.’

GPC negotiator Dr Chaand Nagpaul said his own practice in Harrow, Middlesex, was having problems recovering costs for extended hours. ‘Just getting hold of an individual is proving difficult,’ he said.

Dr Krishna Chaturvedi, a GP in Westcliff-on-Sea, Essex, said his area had seen disputes over a host of LES payments for services such as childhood immunisations and maternity services.

Chasing payments

50% increase in GP appeals for LES payments in first six months of 2012/13 compared with last year

25% proportion of practices chasing LES or QOF payments

7% proportion of GPs considering or taking legal action

£3k-8k: average amount of money owed to GPs