The Secret Diary of a Practice Manager Part 6

So have things really improved with the new CCG organisation set up within the NHS? Are these changes likely to produce any savings for the NHS? More importantly will it improve patient care?

Well in my opinion I cannot see anything yet to think that anything has substantially changed or is likely to. Let me explain and give a couple of examples.


We used to get our monthly payment from the local NHS finance department, but under the changes they have now been transferred to LASCA in Preston.

Payments covering our monthly income in May were a few days late, in June it was on time but no remittance advice was forthcoming. Phone to query this and was told they had been sent out and they would Email me a copy.

The other monthly/quarterly income has now been split in to three different claim processes where as it used to be one.  That would be okay, but in each of the cases, it has been made very difficult for practices to make these claims, as the instructions being sent out are confusing at best and likely to lead to missed payments at worst due to their complexity.

Take for example the DES and minor surgery will now be payable through Open Exeter, we are told to call Lasca to get ourselves log-ins sorted out so we can record achievement and monitor payment.

So I phone to them, and they say, oh no that is incorrect the local NHS has a contact that will sort it all out so phone them.

Sounds good! So I get on the phone to them, yes that is correct but the person who can do it is on holiday back in a few days. Can anyone else do it, sorry no they say.

A week later and still no log on, so I call back, oh that person is off sick, so I say hold on don’t tell me that only one person has such knowledge, where is your business continuity plan, we have it in general practice surely you must have contingencies.

We will see what we can do I am told. A few days later and we are advised that a second person can do it, but in the meantime payments will be made without returns based on the same quarter last year.  Seems like another complicated round of financial checking ahead.

During this period  I attend a monthly CCG meeting where this very issue was raised by others.  Confirming what I had been told, however another  manager said they had no problem and had been given log in by the very same department  that told me they could not do it!!

However at the same meeting mentioned above  I find all my colleagues with the same issue, money in but no remittance advice. I know these are difficult to understand and check but none the less we must have them. My remittance was not the same as the advice note, and so that is being queried.

The local council have taken over some of the payments for the local LES. Claims are meant to be done quarterly. So the first quarter is April-June 13.

We set up the account in good time only to receive an email to say there will be a delay in issuing vendor numbers and so please just hold onto the claim and we should get this within a few weeks.

Sorry but that is just not good enough in my view, so I complained and was told, just ignore that email, send in the claim and they will add on the vendor number this quarter.

Sounds good to me. However at the very same meeting as above other managers have been told that nothing can be done and payments will be held up accordingly.

Is this scenario being repeated across the country?

The cynic in me thinks that this is a ploy to  delay /confuse the payments and I wonder how many mistakes are going to be made where surgeries miss out on the correct payment.

If anyone has a fool proof way to keep on top of all this I would love to know but in the meantime I am sure we are going to be vigilante.

Access Update

In a previous blog I advised of trial of an extra surgery one afternoon a week. This has gone down well as we expected. Each surgery over the 6 sessions were fully booked, however we did note a drop of patients requiring appointments the following day.  So yes we will continue with this but probably not until after the summer.

Practice Manager News Update

I wonder how many other people are as fed up as me in hearing Jeremy Hunt’s new ideas to improve the NHS.   Suggesting that GPs will now be responsible 24 hours a day for patient care is a ridiculous claim.

He is implying that in serious cases the named clinician will be available 24/7 and the public naively think that will be the case. It has been made  to look as though patients can expect their preferred GP to be available 24/7 .

When in fact what will happen is the  surgeries will update their out off hours as we already do with palliative care patients and other serious cases. I am sure that we are not the only practice where the doctor makes calls on the more serious cases at the weekend or on the way into or out of work.

Politicians play with words

A Personal Experience

My wife had been experiencing some stomach problems and visited the GP (Not the one I work for)  and he decided to refer for an endoscopy.  A couple of days later he calls and says he has referred but on a 2 week wait cancer referral, so it can be done quicker and although her symptoms do not tick the box of Cancer it is a way of getting it done quicker. So we were not to be worried when we got the referral through

We have been with this surgery over 20 years and their service has always been excellent.  They are aware of my job and I have been known during a consultation there to mend there printer  or discuss current issues.

Within a week the test had been done the results were known and treatment started. It was nothing serious I am pleased to say   the service was excellent and a patients mind was put at ease sooner rather than later.

I wonder how many other surgeries do the same thing, by referring using the dreaded word CANCER it can speed up the whole exercise.

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