case study
later, I checked my FP69s and whatever work I had done was still sitting there,” she remembers. When she called the PCT, she was told she had done the work on the wrong screen, and would have to do it all again. “Because I was going to go on holiday in December, I thought, OK, whatever, I’ll do it again,” she says. But after doing it again, still nothing happened. This time, the PCT said they weren’t processed because they did not believe that the patients were actually living where they said they lived and should therefore be registered somewhere else. “I could understand maybe 20 or 30 people, but I didn’t believe that all the patients could have moved house,” she comments. But the PCT said that if Lau wanted to keep those patients, she would need to send proof of their address. So Lau sent a letter to the flagged patients explaining that the PCT had reason to believe they no longer lived where they said they did and included a reply card with it. “I received many replies,” she says, “I’ve still got them all upstairs.” The PCT said she need only hold onto these confirmations for audit purposes. At this point it was Christmastime and with little choice left but to wait, Lau left for her holidays. When she returned on 5 January and looked at her patient deductions on the system, there were 645 of them there – the PCT had deducted them all, which meant around £12,000 less in capitation funding, despite all the work Lau had done and all the
proof she had gathered. Needless to say, Lau was furious and called, emailed and wrote letters to the PCT, copying in the then chief executive of NHS Barnet, Cameron Ward, to insist those patients were reinstated, with little reply. Ward eventually came to practice in March and promised it would be sorted – but still nothing happened. “I was totally ignored, which I found totally unprofessional,” says Lau of the experience. “We had a big overdraft on our bank account, as you can imagine; we still had to pay wages and bills.” So Lau called in the Londonwide LMCs, and within a week of doing this had a letter from the new Barnet chief executive saying the practice had £9,000 coming its way. This wasn’t the end of the story as QMAS looks at list sizes on 1 January for QOF payment, so East Finchley had lost out on another £12,000 in QOF money as a result. This was sorted much quicker – and within a week after that, the surgery had its QMAS money. The £9,000 from NHS Barnet came later – sometime in May. “My advice is put pressure on PCTs to
do more, because that’s their only business – patient lists – at the end of the day,” recommends Lau to other practice managers going through a similar experience (though in future, it may well be the NHSCB). “If you are aware of a list cleansing exercise to take
place...find out when.” Then it seems, prepare to defend your rightful list.
It was a nightmare from the time I noticed the 800 FP69s on the system
26 february 2013
people
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