Our PMS baseline includes an amount to cover 12 minor surgery procedures per 1,000 patients. We also provide minor surgery for our own and other practices' patients under a directed enhanced service (DES) contract and we claim for all procedures done under the DES. The PCT alleges it has overpaid us under the DES as it did not take into account the PMS baseline funding for minor surgery.
We do claim for each invasive procedure we perform under the DES but not for cryotherapy because, for PMS practices, this is funded from the baseline. Is this PCT right to claw back the disputed sum?
The PCT is correct in making a clawback of your practice's DES earnings because it needs to compare what is already funded through your PMS baseline to the amount you have claimed.
However, for GMS practices, part of minor surgery is funded through the global sum as an additional service and this does include cryotherapy.
The amount included in the global sum equivalent was one third of their minor surgery income previously paid under the old pre-April 2004 rules.
On this basis you may be able to convince the PCT that it should only compare the claims you have made for the minor surgery DES to two thirds of the minor surgery funding your PMS baseline when calculating the over-payment.
I have been a clinical assistant session at our local hospital for many years. Under a verbal agreement with the medical staffing officer (now retired) it was decided that I would have a free session once month to make up for sessions constantly over running. Two years ago, a new administrator said the arrangement must end and that I should claim overtime pay instead.
Although I do claim for the usual extra hour per week, I seldom receive any extra pay. Can you explain the basis on which the hospital should calculate overtime? Under my original contract overtime was payable on the basis of the total extra time worked in a week divided by 3.5 with payment for an extra full session being made for each 3.5 hours or part thereof.
The latest guidance relating to terms and conditions for clinical assistants, which was issued in 1986, can be found on NHS Employers website at www.nhsemployers.org.
The pay and conditions section states that pay depends on the number of 3.5-hour equivalent sessions required.
The NHS employer must make a general assessment of the average time per week required by an average practitioner in the grade and speciality to perform the duties of the post, including an allowance of up to an hour's travelling time.
It also says there are no permissible additions to basic pay other than London weighting. The DoH has customarily advised that the trust should have regard to actual clinical workload in assessing the number of sessions required.
So, while the guidance does not permit specific overtime claims, it would be worth checking with the hospital how the 'actual clinical workload' is assessed in relation to the number of sessions and whether, for instance, any extra time is taken into account for the over-running of lists within a session.
Can you clarify how much we can charge a solicitor for sending them copies of a patient's medical history and the original notes?
Up to 24 October 2001 the maximum charge for providing copies of electronic records was £10, and for manual records, £50 under the terms of the Data Protection Act 1998.
After 24 October 2001 it was proposed that the maximum fee for copying manual records would be reduced to £10.
However, following a review, the government announced in that the maximum fee of £50 would be retained for the time being. This remains in force.
Note that the fee you charge should reflect the work done.
I plan to retire on 31 March 2008 and I have read that the final NHS pension dynamising factor for 2003/4 has only recently been calculated.
If delays to this degree continue, then the dynamising factor determining my pension's value will be about two years out of date. Will my pension be adjusted later?
Dynamising factors are used to uprate GPs' total, pensionable career earnings to take account of pay inflation. Initially, you will receive a pension based on the interim dynamising factors.
If there is a subsequent increase when the final factors are known, you will receive a lump sum payment in respect of any underpaid benefits to date.
While interest will not be added to this, your future pension income will also be increased accordingly.
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NHS rules: Dr Tim Kimber is a Littlehampton GP and a member of West Sussex LMC.
Stuart Williamson is a partner at accountants Williamson West.
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Maggie Marum is a management consultant for the NAPC and runs its practice-based commissioning helpline.
Call: (020) 7636 8626. www.napc.co.uk
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