British medical clinics face huge backdated bills – Financial Times, 9th May 2016

British health clinics are receiving backdated demands for payments, in one case for about £100,000, as the National Health Service adopts an increasingly commercial approach.

The bills, from the NHS’ Property Services arm (NHSPS), are for services including cleaning, waste management and maintenance.

In April, clinics were told their rent bills would also rise to be more in line with the market, a move that will raise an additional £60m a year for the NHS.

While the government has promised an additional £2.4bn a year to family doctors by 2020-21 to alleviate the pressure on hospitals, the NHS also seems to be withdrawing some of the traditional perks enjoyed by General Practice clinics.

“GP practices are outraged by this; their businesses cannot sustain that level of cost,” said Victoria Armstrong, a partner in the healthcare team of Sintons, the Newcastle-based lawyers.

She said her firm had been contacted for legal advice by about 30 GP practices, and also some Foundation Trusts throughout the North of England. On average, the backdated bills demanded £50,000.

Ms Armstrong said she is aware of similar cases elsewhere in England.

In most cases, she said, there is no clear basis for NHSPS to raise these charges. Some practices are panicking over where such demands might lead in the future, she added.

NHSPS was spun off as a separate state-owned property company three years ago to manage 4,000 buildings, about 10 per cent of the NHS estate.

The company wants to raise funds for the refurbishment and modernisation of its portfolio under Elaine Hewitt, former group property director at BT Group, who was hired last year. It took on buildings formerly owned by 161 primary care trusts, many of which had no documented leases with their tenants.

A GP who received one of the backdated services bills, in an area where recruitment has proved difficult, warned of the potential impact of the demand.

“If we paid this we would have serious cash flow problems; the obvious way out is closure,” he said. His four-partner practice in north-east England has received a bill for an additional £100,000, around 10 times its previous service charge. “This is a dagger pointed at our practice’s ability to function,” he added.

A key flaw in increasing costs for GP practices, he said, is that they cannot pass on higher charges to patients. He also considered NHSPS’s cost estimate for cleaning to be far too high.

NHSPS said the change had been signalled since the health reforms of 2013, in order to make costs “truly transparent” for the first time.

“As part of professionalising the way the NHS estate is run, all occupiers are now billed in a way that fully reveals the actual costs of running their buildings and services,” it said. “We recognise that some year-end costs will appear higher but these are reimbursable through arrangements announced by NHS England as part of the GP Forward View.”

NHS England said: “As it has only just been announced we are still clarifying the details of how it will work.”

Chris Tighe & Judith Evans, Financial Times, 9th May 2016.

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