Capita has been responsible for the delivery of NHS England's primary care support services since 1 September 2015, under the name Primary Care Support England (PCSE).
GPs and LMCs identified serious issues with the service from the outset, with patient safety, GP workload and GP finances being affected.
GPC have been meeting with NHS England and Capita to highlight the ongoing issues, and some progress has been made following our lobbying. However, services still fall short of what is acceptable and there is still an urgent need to resolve these issues in order to give practices and locum GPs confidence in the service.
PCSE claims guidance
We are aware that practices have been experiencing issues with primary care support services in England, commissioned by NHS England and provided by Capita. The issues have been ongoing for some time and we are aware of cases where practices or individual doctors have suffered losses due to the failing of these services. We believe practices and individuals that have suffered losses as a result of these issues should be compensated.
In recognition of the additional administrative burden on practices, a goodwill payment of £250 payment per practice is being made by NHS England and this should be paid to practices by 30 June 2017. This payment should not prohibit those who have suffered a demonstrable loss from being recompensed. Practices or individuals who can provide evidence of the financial loss they have incurred as a result of Capita's failures can contact NHS England to make a claim.
These losses might be, for example:
- Direct losses - where there is a clear requirement for a payment to be made under a contract
- Indirect losses - costs incurred as a result of having to take out a loan to pay for practice expenses or a GP who has not been able to work because of delays getting onto the performers list.
This list of losses is not comprehensive and there may be other types of losses suffered for which a claim can be made.
GPC believe that NHS England, as the commissioner of this service, have a responsibility to recompense practices or individual doctors who have demonstrable loss as a direct result of failures by PCSE.
Those in this situation should send an email to NHS England at their designated email address [email protected]. Claims will be logged, acknowledged and appropriately reviewed, seeking further information from the correspondent as necessary.
The purpose of this arrangement is to provide a co-ordinated way for practices and individuals to raise issues which have had a detrimental impact. Inevitably there will be issues raised that NHS England is either unable to consider or resolve and correspondents will be advised accordingly about these.
Every case is different, and the BMA cannot advise on individual cases. In general, we would suggest that you give consideration to including the following details in your email:
- Your name and address (or the name of the practice and its address)
- The reason for your claim
- A clear explanation of the facts
- What losses are you are claiming (these may be direct losses such as your contractual payments, or indirect losses such as costs incurred as a result of having to take out a loan to pay for practice expenses)
- Attach any supporting documents which verify the facts in the letter and the amount claimed
- A date by which you want a full response, we recommend 28 days
- Any other relevant information
You should note that by accepting an offer of compensation it could mean you forego the right to seek any further redress, so please consider fully all losses that you suffered as a result of failings by PCSE.
If you are not satisfied with the outcome of your claim to NHS England, you may wish to consider taking up your claim via the small claims court, however not all claims are suitable for this route. Read our guidance on bringing a small claim to court.
If you cannot reach agreement with NHS England over your claim, contact GPC [email protected] or your LMC for further advice and support.
If you are unsure about the terms of any offer or about your legal rights, we recommend you seek independent legal advice, however, depending on the financial loss you have suffered, this may not be financially prudent.BMA Law offers expert legal advice at preferential rates for BMA members. They can be contacted on [email protected] or 0300 123 2014.
What GPC are doing
Since July 2016, GPC have been using a robust exercise to identify the extent of the issues and to assess whether there is any marked improvement in the service being delivered by Capita. See the timeline below for more details.
Capita assure us there will be a marked improvement to their systems and services by the end of July.
Throughout July GPC undertake an exercise to identify the extent of the issues and to see if any suggested improvements have been visible.
GPC undertake another round of the exercise to assess whether the issues previously reported are still prevalent and if any improvement has been made during October.
GPC provide the results of the exercise to NHS England at the beginning of November as well as writing to highlight a specific issue with GP trainees pay.
Expand the headings below to see the results and more details
GPC monitoring of Capita performance
Details of the assessment exercise
GPC used the following criteria to monitor the performance of Capita:
- For patient records delivery/collection, the situation does not appear to be improving, with a sharp increase in the last week for average number of records awaiting delivery.
- For supplies, the situation has improved, with more practices reporting they are receiving all ordered supplies on the expected date.
- For the PCSE customer support centre, there appears to be no improvement in issues being resolved via telephone or via email, across the four weeks, with high numbers of practices consistently reporting issues are not resolved.
- For new patient registrations, following a small decline, the percentage of practices reporting that new patient records are processed within the three day timescale, showed some improvement but remained at an unacceptably low level overall.
- A vast majority of practices reported that they do not have contact with their local NET team (although this improved slightly over the four weeks).
- The percentage of practices reporting issues with payments to their practice, reduced substantially over the four weeks with a steady week on week reduction of incorrect payments.
GPC England has been made aware that due to the failings of PCSE, some trainees have not been paid. While it is the responsibility of the practice as the employer to pay their trainees, if the employer has not been provided with the required information and/or the required funding, they may be unable to do so.
GPC England Chair, Chaand Nagpaul and GP Trainees Subcommittee Chair, Samira Anane, wrote to NHS England to seek an immediate solution to ensure no trainee is left unpaid, and to ensure that no practice has to dip into their overstretched budgets to make up the shortfall in funding.
Read the letter
GPC designed a proforma to send to GP practices in England with a number of specific questions on the most widely reported issues. Practices completed the proforma on a weekly basis and returned to their LMC, who collated all practice responses from their area and returned to the GPC, who performed the analysis.
- 72% of practices received records delivery/collection on the expected day
- 81% of practices reported that urgent requests for records had not been actioned within three weeks
- 69% of practices reported that they had not received incorrect patient records
- 77% of practices reported that they had received all supplies ordered on the expected date
- 51% of practices reported that PCSE customer support staff are unable to resolve issues within an appropriate timeframe
- 51% of practices reported that PCSE customer support staff do not provide a helpful response by telephone
- 66% of practices reported that they do not receive a response/resolution by email
- 58% of practices reported that new patient registrations are processed within three days
- 74% of practices reported that they do not have contact with the NET team
- Pensions deductions and trainee reimbursements were the top two incorrect payments
Download the full report
You can download the full report which contains detailed week-by-week comparisons.
Main issues which were highlighted include:
- Serious problems with the management of patient records, including:
- long delays in collection or delivery of records when patients transfer from one practice to another
- Failure to process urgent requests for records in a timely manner if the patients has an immediate emergency
- Large build-ups of records awaiting transfer to a new practice
- Wrong records delivered to practices resulting in time wasted by the GP attempting to reroute them.
- Records not being updated so they often appear with patient's previous addresses on records.
- Failures in maintaining supplies to GP practices, including GP practices suffering shortages of key materials like prescription pads, fit note certificates and syringes.
- Mistakes in updating the local Performers list which is supposed to be kept constantly up to date with details of GPs allowed to practice in the NHS.
- Information transfer failures, with practices not receiving the information they used to receive (i.e. how much to pay each trainee, how to process new starters etc)
- Customer Support Centre staff not appropriately trained, often struggling to answer queries on the phone (telling practices to email their generic email address) and not transferring calls to appropriate departments because of backlogs.
Further discussions and correspondence took place during August and September, with NHS England and PCSE, in order to highlight the continuing issues.
You can read the correspondence and download the catalogue of feedback received from LMCs:
Read the news story
Read the press release