Are we dealing with ‘ghosts’?
Don’t you wish you could grab hold of someone at Capita and throttle them?! Records are not arriving and now payments not being made. As an ex-FPC manager, I could be proud of the work we did to keep general practice running. The staff were knowledgeable and helpful, and whilst I am sure there were mistakes, payments were normally made promptly and correctly. Notional Rents were reviewed and Items of Service claims were processed. In the past, you would have known someone by name at your local office of a PCT or NHS England. But the named individual in Capita is like a ‘ghost patient’.
Payments are a ‘no show’
Now I read and hear about the problems practice managers encounter trying to get payments made to their practices that simply used to flow without a problem. It is sad that in these days of computerised payment systems, managed by Open Exeter, that those that who deal with and approve GP payments cannot get their act together. It is also sad that practice managers must spend a ‘considerable’ amount of time monitoring incoming payments, and then trying to chase missing payments. Even a few years ago, I found myself checking payment statements with a fine toothcomb as I realised that the people I was dealing with were not tuned in. It sounds to me that the time has come to muster the troops and start firing bullets. But what bullets can you fire? Here is my list of ‘bullet’ points!
- Primary Care Support England
The body responsible for authorising payments is the first port of call, if you can ‘dock’. However, reports suggest that practices are struggling to make contact with anyone and rarely receive replies to emails or complaints. They might just as well be based on Mars! But you need to lodge your complaint in writing with the PCSE, and copy it to your MP.
- Local Medical Committee
The Local Medical Committee represents the GPs working in your area and you should make the secretary of the LMC aware of the problems you are experiencing with NHS payments and ask for their support. The LMC may already be making representations to the GPC.
- GP committee
Muster members of the BMA’s General Practitioners Committee of which Dr Richard Vautrey from Leeds is Deputy Chairman. Whilst I am sure he and other members of the GPC are well aware of the problems GP Practices are encountering, it will do no harm to keep them informed. He often has coverage in the medical press. The GPC is already monitoring the situation and has exchanged letters with NHS England which can be viewed online here.
- British Medical Association
The BMA should be in a position to offer members advice on tackling non-payment issues, and have a direct link to the GPC. If one or more of your GPs is a member of the BMA, then seek advice about how to deal with the problem. Keep the BMA in the loop. There is more information on their website.
- Clinical Commissioning Group
The Clinical Commissioning Group should be working with its practices to address problems of non-payment. Use meetings to publicly air concerns.
- Local practice managers group
The practice managers group, if you have one, should work together to combine its efforts to address the issues of non-payment and failure of the PCSE to transfer records. A joint letter to PCSE might be worth a try.
- Medical Defence Union or Medical Protection Society
Your defence organisation also ought to be in a position to advise your practice on the options available to you, and suggest ways of legally challenging the PCSE for failing to make payments.
- NHS England Area Team
Your area team’s officers need to be kept up-to-date with the problems you are experiencing. Their level of interest might be poor but it is just another ‘butt’ to kick. I can hear the excuses now!
- Care Quality Commission
I am not sure that the Care Quality Commission has taken much interest in financial matters during its inspection programme, however, it seems to me that ‘being paid on time and correctly’ is fundamental to running a safe practice, not just the people and their knowledge and skills. Inspectors, in my opinion, need to be made aware of the inadequacies of other parts of the NHS. Go on ‘whistle-blow’.
- Member of Parliament
You have the right to approach your local member of parliament on any issues that concern you or your practice. This may open a line of communication with the Secretary of State, who may respond to any challenge. I have found in the past that there is always a response, although it may take a few weeks. Recently I have had answers on transferring records using the GP2GP transfer system, on complaints to the NHS Ombudsman and on VAT. You need to tell your MP, maybe at his or her weekly ‘surgery’.
- Secretary of State
And finally, have you thought of legal action? Non-payment of claims, in effect, is a bad debt. Your suppliers would threaten you with court action if you did not pay a bill. I recall an invitation to attend the Magistrates Court after I took over a new practice – No-one had mentioned that business rates were not paid by direct debit! There is often a reluctance to shout too loudly, yet sometimes a concerted action can make a strong and valid impact.
- Press release
Have you considered a press release? Have you informed your Patient Participation Group? I did come across an example of a surgery having problems with payments for the rent of a surgery to a private landlord. Not very comfortable for the practice concerned but it did hit the local headlines.
And finally, don’t forget that there is a petition running to seek a debate in Parliament on the inadequacies of Capita. The point of this article is to suggest that you don’t just sit there and take it. Network with others and press for an immediate improvement before your practice ends up in ‘dire straits’. Use this website’s Forum to keep your practice manager colleagues well informed.
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