An internal NHS report seen by The Times and the Health Service Journal has revealed how GPs could receive payment twice for visiting residents in care homes.
Clinical commissioning groups (CCGs) which control how £67 billion of taxpayers’ money is spent on services ranging from GP surgeries to occupational therapists to dementia care, are described as vulnerable to conflicts of interest and lack of accountability.
For example, GPs who sit on CCG boards often commission services for their own practices.
CCGs were created following the Health and Social Care Act in 2012, and replaced Primary Care Trusts on 1 April 2013. They are clinically-led statutory NHS bodies responsible for the planning and commissioning of health care services for their local area. There are now 211 CCGs in England.
GPs at a recent British Medical Association trade union meeting voted in favour of a motion to stop visiting elderly residents in care homes, raising the possibility that more and more care home operators will have to pay for GP services.
If GPs follow through with this threat, there would be a risk of them recouping payment from taxpayers via the CCG, and again directly from private care home operators.
The internal NHS report found an example in the London borough of Barnet where doctors failed to register that they were being paid directly for care homes visits, leaving open the possibility that they could claim payments for the same visits from their CCG.
Meg Hillier, chairwoman of the public accounts committee, told The Times she was worried that spending was devolved without accountability. “GPs have got to see their role as public servants spending taxpayers’ money and understand that rules need to apply … there are meant to be safeguards inbuilt, but they are clearly not working in some places,” she added.