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Lawyer brands NHS England's historic MUR fines 'shameful'

David Reissner predicts NHS England's fines could run into millions of pounds

A leading lawyer has condemned NHS England’s attempts to claw back medicines use review (MUR) fees from West Midlands contractors if they have not completed their information governance toolkit.

David Reissner, senior healthcare partner at law firm Charles Russell Speechlys, said he believes that 150 pharmacies have been served breach notices by NHS England's regional team for the West Midlands, saying it will deduct sums that “often run into tens of thousands [of pounds]”.

“It is a shameful attempt by NHS England to try to claw back fees that pharmacies have legitimately earned by carrying out MURs, which have a beneficial effect on the lives of many patients,” Mr Reissner said.

The regional team has "served the breach notices at the busiest time of year”, added Mr Reissner, as the time limit for appeals will expire on December 30. “NHS England could not have made this more difficult for pharmacy owners if it tried.” 

In November, C+D reported the case of a West Midlands contractor who was fined £15,000 across several branches by NHS England without notice. Mr Reissner said his firm is dealing with appeals from almost 30 similar cases.

The total sum involved in these cases already exceed £250,000, said Mr Reissner, who estimates the money that the regional team is trying to recover could run into millions of pounds.

“NHS England is unjustly trying to enrich itself by allowing pharmacists to carry out MUR payments and then afterwards saying [they] are not entitled to be paid,” he said. “The NHS is trying to get thousands of MURs for free.”

NHS England has “not followed regulations”

Mr Reissner stressed that NHS England is not entitled to serve contractors breach notices without first having made every effort to communicate with them.

“This is a statutory requirement that we say hasn’t been met,” he said. “The notices are all invalid.”

Pharmaceutical Services Negotiating Committee (PSNC) director of operations and support Gordon Hockey said the negotiator is “very concerned” NHS England's regional team for the West Midlands does not appear to have followed pharmaceutical regulations and associated guidance when reaching decisions to withhold remuneration from contractors.

“We have escalated this issue to the senior management team within NHS England,” Mr Hockey told C+D.

“We understand that sums withheld range from £56 to £30,000 depending on the number of years the information governance toolkit was not completed.”

NHS England's response

Richard Yeabsley, head of primary care at NHS England West Midlands, told C+D today (December 22) that it is "appropriate" that NHS England "recovers monies that should not have been paid".

The MUR clawbacks are "not fines", said Mr Yeabsley, but instead are "recoveries of monies paid to contractors to which they were not entitled". 

"NHS England will consider any requests for different repayment terms based on individual contract circumstances. Contract holders have been invited to contact NHS England.”

Mr Yeabsley stressed that the annual completion of the information governance toolkit is an "essential" part of the contract for the delivery of MURs. 

"NHS England has a duty to ensure that patient information is managed safely and appropriately," he added. 

What is the information governance toolkit?

The information governance toolkit is used to demonstrate that contractors have systems for maintaining data protection and confidentiality, and is part of the terms of service for pharmacy owners.

Pharmacy contractors in England were expected to publish their toolkit submissions for 2015 by March 31 this year. The deadline for submitting this year's return is March 31, 2017.

More details about information governance submissions can be found on PSNC's website. Scotland, Wales and Northern Ireland are subject to different arrangements.

Have you recieved a breach notice from NHS England?

Valentine Trodd, Community pharmacist

No doubt the good Mr. Reissner will be on call to offer legal guidance to the 150 pharmacies involved... for a fee.

Farm Assistant, Community pharmacist

How much more of this bullshit do we have to put up with? All Mr Yeabsley cares about is his pension, typical useless bureaucrat. Hitler would have had no trouble with helpers if he had ever suceeded invading. The only answer is a complete strike by every working pharmacist. See how long any government would last if people could not get their drugs....all those happy tablets, PPi s etc. Happy Christmas everyone and let's look forward to an even worse New Year.

Frustrated Pharmacist, Community pharmacist

MURs are a shameful box ticking exercise in themselves.

Jupo Patel, Production & Technical

Law really is a fantastic profession. They'll first condemn' it then suggest fighting it out in court for a 'small fee' safe in the knowledge of whole futility of it anyway. Quite  fantastic.

A C, Locum pharmacist

And if the boot was on the other foot i have no doubt contractors would be screaming about unfair it is they are owed money by NHS England. The contractual requirements are clear. If you don’t adhere to them why should you be paid!

Jonny Johal, Pharmacy Area manager/ Operations Manager

The requirements to complete the toolkit was made known to all contractors, it is up to them to comply. A breach is a breach, do contractors need to be informed before they know that they have breached? I always knew where I stood with this and never needed reminding. I think those who failed to complete the toolkit (for years, in some cases) chose to do so, and should be man enough to take the consequences.

Jupo Patel, Production & Technical

Said like a good servant. You'll get a pat on your head from your master no doubt. Good boy/girl.

Angela Channing, Community pharmacist

Multiple robot! 

Jonny Johal, Pharmacy Area manager/ Operations Manager

If that's all you can say, I take it as a compliment. A robot I may be, at least I make sure our contract is not breached, people's jobs depend on it, and I have never claimed monies for which I am not entitled.

Jupo Patel, Production & Technical

Well done. Good boy/girl. 

Reeyah H, Community pharmacist

An absolute joke. The clawback was shown on the statements BEFORE any warning whatsoever. Then a letter arrives 'hinting' at it all and finally breach notice AFTER the hit. Don't know any industry which behaves like this! 

Keith Howell, Primary care pharmacist

Shocking. At xmas too. No class.

Paul Dishman, Pharmaceutical Adviser

The IG toolkit is easy enough to complete, but its a box ticking exercise and adds zero value to patient care. It is, however, just the sort of thing that the trouser polishers in NHS England love.

Angela Channing, Community pharmacist

I blame Tony Blair for all this "box-ticking" and nobody is any better for it.   Look at Baby P and all the child protection deaths/cases, all boxes were ticked, and still they died. Ticking a box doesn't mean the job has been done. ! I hope Mrs May, in hopefully her decade in power can sort all this crap out, and while she's at it, get rid of all these ridiculous salaries in the public sector which are 2 or 3 or 4 times her salary and she is running the country!!!!  New Labour have a lot to answer for. But as things stand at the moment with JC and co, they won't be allowed anywhere near the offices of power after the shambles they left in 2010. And No, I'm not saying either that Dave and co were perfect, because they weren't, but this country needs a damn good shaking up,  ALA Maggie 1979 style,  I just hope Mrs May is up to the job. 


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