Unpaid fees worth more than £10,000 in some cases have compounded cashflow problems caused by repeated GP pay freezes, PMS reviews and other income changes such as prevalence weighting on QOF.
Accountants estimate that as many as one in 20 partners have been forced to reduce their drawings, or temporarily halt them.
Practices have also faced threats of fines from banks due to exceeding overdraft limits.
Laurence Slavin, a partner at specialist medical accountants Ramsay Brown & Partners, said: ‘I have seen practices where partners have not taken drawings for a couple of months. I think most practices are affected by the cashflow. Maybe one in 20 will have had to stop drawings or cut them.’
He said that PCT clustering and the departure of key staff meant some practices might never be paid for enhanced services they had delivered.
Mr Slavin said a practice he represents was ‘now pretty sure it won’t be paid’ for providing a local enhanced service (LES) over a quarter of the financial year. ‘Finding someone who knows about the LES and that they should have been paid isalmost impossible,’ he said.
Fear of persecution
Mr Slavin said if PCTs refused to pay, practices were often unwilling to challenge them through the NHS Litigation Authority for fear that they would then be ‘persecuted’.
Enhanced services were often paid quarterly, rather than monthly with other income, so some practices could be out of pocket for months before annual reviews with accountants picked up the shortfall.
‘Minor surgery can be worth £2,000 to £3,000 a quarter – it’s not difficult to find yourself nine months out of pocket. The balance is £10,000 easily down. That could take you over your overdraft limit,’ Mr Slavin said.
Richard Vickery, senior manager at PKF accountants, predicted more missed payments and advised practices to check statements from PCTs monthly. ‘As more staff are culled we expect problems to increase.’
GPC negotiator Dr Chaand Nagpaul said because of the ‘rushed reorganisation’ practices were experiencing missing or delayed payments or receiving unidentified payments.
* Read Mr Slavin's Money Talks blog exclusively at GPonline.com.