This story was first published in digitalhealth.net
Practices to receive withheld DES payments after NHS relents
GPs who have had their directed enhanced services (DES) payments withheld and have met the minimum standards for avoiding unplanned admissions will receive payment, after a nationwide review by NHS England.
Originally, NHS England had claimed that certain practices were not eligible for tens of thousands of pounds worth of funding, despite following the guidance in the specification. One instance includes a case in East Anglia, where NHS managers had withheld payments to all practices, including those who fulfilled the requirements to NHS England’s satisfaction.
However, following the review NHS England has issued new guidance which instructs teams to pay any practice that has met the minimum standard of putting 1.8 per cent of their patients on the DES risk register.
Before payment can be issued, area teams will be required to manually calculate practices’ achievement which may lead to further delays in payments.
The problems are a result of a dispute between NHS England and the General Practice Committee (GPC) concerning how often practices must complete a review of existing care plans to trigger payment.
GPC guidance directs that practices should review care plans for their at-risk patients in the 2015-16 financial year, thereby giving practices extra time to undertake the reviews.
Nonetheless, NHS England claims that practices actually had to review care plans in the last 12 months and withheld payments for practices that had been planning to carry out reviews later on this financial year. NHS England has assured that practices will receive the money even if they have not yet reviewed their care plans this financial year, and maintains it was not its ‘intention to withhold payment where the work had been completed’.
It recommended that: “Any practice that has achieved the minimum 1.8 per cent but has technically ‘failed’ due to having insufficient updated care plans, or having failed to record allocating an accountable GP, should receive the mid-year payment.”
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