GPs fear pay chaos as NHS consults on admin cuts

Cuts to NHS back-office services could cause 'absolute chaos' over payments to GP practices, an LMC leader has warned, as NHS England area teams began consulting practices over proposed changes.

Dr Robert Morley: payment chaos fears
Dr Robert Morley: payment chaos fears

NHS England plans to slash funding by 40% to Primary Care Support (PCS) services, formerly known as Family Health Services, which administer GP payments and patient records.

The cuts, first revealed by GP in September, could see the number of regional FHS offices slashed from 37 to 12 and savings of £40m targeted from a £100m overall budget.

In a letter sent by the Birmingham, Solihull and Black Country area team, director Wendy Saviour said she would be seeking the views of practices.

‘We are especially interested to have feedback on the proposed new operating models to ensure that the new service design continues to meet the requirements of our customers.’

But Birmingham LMC executive secretary Dr Robert Morley said he feared the consultation was a ‘cosmetic exercise’.

‘I recommend to practices that they do respond robustly to it, but it’s pretty clear these savings are going to be found regardless and it’s going to put a lot more hassle and bureaucracy on practices and support staff who are already groaning under the strain,' he said.

Dr Morley warned the cuts would mean local, experienced staff would be lost. ‘I can foresee there will be no one left from the days preceding the PCTs,' he said. 

‘I can imagine problems with payments to practices that could make what we’ve experienced over the past 12 months seem a drop in the ocean.’

In a separate development NHS England revealed cost cutting by commissioning support units (CSUs), which provide admin functions for CCGs including processing payments to GPs, could result in redundancies for around 300 staff, or 3% of the workforce.

NHS England said it supported the need for CSUs to find efficiencies so resources could be focused on frontline services.

CSUs, currently hosted by NHS England, are set to be made independent in 2016, although officials have ruled out wholesale privatisation for now due to lack of support from CCGs.

PCS services also face possible future outsourcing. About 30% of 27 area teams provide primary care support services in-house, with the rest outsourced to NHS Shared Business Services (SBS) or private providers such as Serco.

GPC leaders have warned the changes could create further practice payment problems following chaos caused by the introduction of new systems in April 2013.

Deputy chairman Dr Richard Vautrey said those problems had settled down following intervention by the GPC, with fewer new problems being reported.

New guidance for practices has been issued by NHS England on National Health Application and Infrastructure Services (NHAIS) statements and Shared Business Services remittance, which is due to be sent to practices.

NHS England said improvement to NHAIS at the end of last year made it easier for practices to match payments with details of what the payment is for.

Officials have advised CCGs on BACS payment timings and passed on concerns over payment problems to the Local Government Association and Association of Directors of Public Health.

A spokeswoman said NHS England was not aware of any new new issues, but was ‘keeping the situation under review’. 

Dr Morley said he believed the payment problems had started to settle down. ‘But if our local office closes and practices lose contact with staff they have known for many years, and get people who are far more remote and who aren’t as experienced in the complexities of practice payments and registration processes we may get more even more absolute chaos.’

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