Exclusive: GP payments face fresh turmoil

GP payment systems could be overhauled again just months after NHS reforms caused chaos to practice funding.

Dr Tony Grewal: further changes risk repeat of payment chaos
Dr Tony Grewal: further changes risk repeat of payment chaos

NHS England has set up a central unit to oversee its area teams' administration of payments to GPs after practices across the country faced months of uncertainty caused by missed, late, and unidentified payments, GP has learned.

Discussions within NHS England are ongoing on how to make payment systems inherited from PCTs more consistent.

NHS England is working to address technical problems that emerged when responsibility for payments transferred from PCTs to its area teams, but is also looking at reform of family health services (FHS) administration services.

NHS England is understood to favour a move to outsource all administration of FHS payments to specialist regional providers, but has stressed no decisions have yet been made.

Around 30% of area teams currently have in-house staff to administer the payments, while others contract the service out to providers.

GP leaders, however, fear the plans could exacerbate problems.

Speaking to GP, NHS England's head of primary care commissioning Dr David Geddes said fragmentation of the payments system had caused recent problems, and there was a need to 'consolidate'.

An NHS England spokesman said since taking control of FHS payments in April, NHS England had found services provided to GPs 'vary greatly throughout the country'.

He said discussions about how to create consistent support services were at an early stage.

Dr Tony Grewal, medical director of Londonwide LMCs, said GPs would fear further change may exacerbate problems.

The payments system introduced in April had proved a 'complete disaster' for GPs, said Dr Grewal.

'If we return to a national or regional version of the old PCT finance department that handles all payments, that could only be an improvement.'

But he warned: 'My confidence in NHS administration to deliver something that is an improvement on what went before has been somewhat shaken by the events of the past 20 years.'

Chief executive of Lancashire and Cumbria LMCs, Dr Peter Higgins, said he was sceptical about whether changes could make a difference.

'What is needed is a fundamental review of the whole damn payment process. It's a shambles,' he said.

LMCs across the UK report that problems with missed payments and unidentifiable payments to practices are an ongoing problem.

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