Keeping your finances healthy

In my second Healthcare Accountancy article, I have focused on two areas relating to GP practice funding, COVID-19 reimbursements and an increase in funding for practices hosting undergraduate medical students.   

COVID-19 additional costs reimbursement window

In a letter sent to NHS managers on17 March the NHS chief executive, Simon Stephens confirmed that ‘to ensure that practice funding does not influence clinical decisions during the current outbreak of Covid-19, QOF and other enhanced service funding will be protected at the same levels as prior to the outbreak’ it was also promised that additional surgery costs would be funded by the NHS.

On 4th August this commitment was brought into effect when NHS England in a letter to GP surgeries confirmed that claims can now be made for practice reimbursements from the COVID-19 Fund

All GP surgeries can now claim reimbursements for additional costs incurred between 23rd of March and 31st of July, relating to the pandemic; specifically, staff and partner absenteeism and the cost of other net additional expenditure. This includes items such as:

Additional clinical equipment required to deal with the pandemic such as Oximeters metres and digital thermometers etc,

• The cost of minor physical adjustments to buildings such as Perspex screens and barriers, and,

• Additional cleaning materials

• The cost of bank holiday opening on Good Friday and Easter Monday and the May Bank Holiday at the following rates: sessional GPs up to a maximum of £250 per session or £500 per day, over time, pathology, other GPs in line with their contractual arrangements, up to £299 per session for GP partners for up to 2 additional sessions and overtime for other GP practice staff in line with their contractual arrangements.

• The cost of staff absenteeism is from day one of absence where it was required to maintain clinical capacity and if the staff could not work from home. These costs can be claimed for the period 23rd of March to 31st of July.

• The cost of providing support to care homes as described in the NHS letter to surgeries, surgeries can claim for these costs until the end of September.

It was also announced in this letter that the DHS see will also provide funding to cover the costs of personal protective equipment purchased by surgeries. No date was given as to when these PPE claims can be made however, they mentioned that this will be soon.

Many practices have already submitted claims and the local agreements for additional costs relating to dealing with the pandemic, however, if these claims were outside the scope announced in the letter additional amounts may need to be repaid. In the appendix to the letter the NHS said ‘commissioners may require an appropriate portion claims to be repaid or set off against practice global sum or such other monies due under the GP contract if the funding was outside the terms of this guidance’, however, the commissioners have been given some leeway as the appendix went on to say “commissioners should consider every exceptional circumstance in making these judgements. In assessing support”.

The appendix to this letter includes a declaration form that is used to make the claim for reimbursements, copies of invoices, receipts and timesheets will need to be attached to this.

NHS England has also confirmed that a Post-Payment Verification will be carried out on a sample of claims, particularly relating to additional costs of maintaining care home services, this will include comparing both pre and post COVID-19 service levels.

Claims that need to be dealt with quickly as surgeries were given a six-week window from 4 August to make their claims so the window of opportunity will close on 15th September.

The additional costs incurred due to this pandemic have been substantial for most surgeries and accountants should take this opportunity to remind GP’s and Practice Managers that these claims should be made without delay.

A new minimum payment of £28,000 is available to GP surgeries for hosting medical undergraduates.

In 2019, a study carried out by the UK head of undergraduate GP teaching group concluded that the cost of taking on an undergraduate medical student was estimated to be approximately £40,700, whilst the average amount of funding paid to surgeries was just £22,000.

The government has also announced that funding will be given for an additional 250 foundation years students and that current medical student numbers have increased by 15%.

To cope with the increased number of students expected to move into General Practice as a speciality the Department of Health and Social Care has announced the payment to surgeries for hosting students, although negotiated locally will not be lower than £28k.

If you have any clients that are training practices the average funding hosting students will increase by around £6,000 p.a.

The minimum rate will be for 2020/21 and will commence ‘when general practice placement activity resumes in 2020/21’.