We've met with NHS England to discuss the audit and set out our initial concerns. We will be meeting them again this week and will ensure that the profession is kept updated.
NHS England is asking contractors to audit a sample of 20-30 patients where a New Patient Premium (NPP) was received to confirm that the patient was ‘new’ under the scheme.
We have been assured by NHS England that this is about verifying the accuracy of the system of the NHS Business Services Authority (BSA), and its ability to accurately determine whether a patient was ‘new’. It is not questioning the integrity of contractors. The allocation of NPP payments was made by the BSA, and contractors did not submit a claim for these payments.
The patients to audit will be those where the BSA system was not able to use an NHS number to exactly match to patient records and so had to use name, date of birth, and other identifying information. Due to alternative spellings, use of middle names and other factors it is possible that the BSA has incorrectly matched some patients and therefore incorrectly allocated NPP payments.
The NHS BSA will provide contractors who were eligible for the NPP with a letter about this audit and the patient sample to be reviewed today. Contractors will have until 28 July to review whether the patients were ‘new’ to the practice or not.
Where the patient is found to have been incorrectly designated as ‘new’ by the BSA’s system, then the payment related to these patients will be recovered. NHS England has confirmed that the contract’s year-end position will not be affected by this. The recovery of any NPP payments will not lead to a recalculation of the year-end position, and so contracts will not end up being subject to clawback as a result of this audit.
Where NHS England recovers money from the practice, and subject to the terms of the associate agreement, it is likely that the repayment of the incorrectly assigned extra UDAs will be shared between the associate and the practice.