GP practices across the UK have been losing ‘tens of thousands’ of pounds

GP practices across the UK have been losing ‘tens of thousands’ of pounds due to a discrepancy in data that has led to a ‘chronic underpayment’ for care home patients, practice managers have revealed.

It has written to ministers, the chief executives of NHS England, NHS Wales, NHS Scotland and ICBs seeking urgent financial redress for practices.

The IGPM explained the discrepancy ‘goes back several years’, arising after a change to the clinical system coding for patients in residential institutes introduced by PCSE in 2021 but that practices have been unaware of.

The Institute went on to highlight that care home patients are given more funding – they attract a factor of 1.43 to the global sum payment, which is an uplift of 43%.

‘At even a variance of 100 patients for a practice, that is c.£4.5k lost in global sum income in 2023/24 alone,’ it calculated.

In their letter to ministers, the directors of the IGPM acknowledged that it is the responsibility of each practice to add the correct residential institute (RI) code to patient records.

However they said: ‘The level of disparity across so many practices does suggest that this change was extremely poorly communicated.’

Practices don’t recall being made aware of the change, they added.

They went on to explain that the issue has only become more visible to GMS practices with the more detailed PCSE statements than with the previous Open Exeter ones. ‘It has helped us in the identification of how widespread the issue is and helped some practices fix the issue.’

However, the IGPM warned, PMS practices who receive less frequent statements weren’t able to identify the problem until alerted to it.

The body also noted it was concerning that ICBs did not pick up the issue, failing to ‘identify that the number of care home patients for practices within their ICBs was significantly different to the number of care homes that they were paying for under the PCN DES.’

Full Article from Management in Practice