NHS England to start spot-checking NMS payment claims this month

A sample of contractors will have to provide evidence to support NMS payment claims (credit: PSNC)
A sample of contractors will have to provide evidence to support NMS payment claims (credit: PSNC)

NHS England will begin spot-checking selected English contractors' new medicine service (NMS) payment claims in the next stage of its national pilot.

From mid-January, the NHS Business Services Authority (NHS BSA) will start to “request evidence” from contractors to support their NMS payments claims over a three-month period, according to the Pharmaceutical Services Negotiating Committee (PSNC).

Same process as MUR payment checks

Alastair Buxton, PSNC director of NHS services, said the post-payment verification for NMS would “follow the same process” as that used to verify contractors’ medicines use review payments, which began in October 2017.

“The NHS BSA will request evidence from a sample of contractors, including those identified as being outliers due to having made very high claims for the service in the month in question compared to the average for all contractors, and a random selection of other pharmacies,” Mr Buxton said.

To prepare, all contractors should review how they currently file signed patient consent forms, said Mr Buxton, who also stressed that only contractors contacted by the NHS BSA will need to submit their NMS forms.

“It is expected that post-payment verification of claims for the flu vaccination service will be the next advanced service to adopt this process, but there is no date for the implementation of this as yet,” he added.

“Standardising the approach”

NHS England asked NHS BSA to pilot a national process for parts of the post-payment verification and performance management of advanced services, in order to take a “standardised and centralised approach”, PSNC said.

The standardised approach aims to “identify any issues related to the claiming of payment for advanced services” and to "facilitate resolution of those issues with the individual contractor," the negotiator added.

5 Comments
Question: 
How do you think the NMS service could be improved?

Jonny Johal, Pharmacy Area manager/ Operations Manager

I totally support this move, my employers will appreciate my efforts in not doing any NMSs now, because there is no chance of me getting them in trouble on that score.

Valentine Trodd, Community pharmacist

This is a load of nonsense. I received such a 'probity check'. All they did was check the number of signed consent forms matched the number of claims for each month. If you're going to fake MURs/NMS, the least you'll do is fake signatures on consent forms. How about some proper follow-ups with patients? I bet there would be a fair few confused phone calls... "MUR? What's an MUR?"

Syd Bashford, Community pharmacist

Do the GP’s ever need patient signatures and requested proof ?We just can’t be trusted as a profession can we..... !!!! We just can not be trusted eh? What a wonderful feeling of respect from our NHS employers.

Sue Per, Locum pharmacist

How could you possibly blame them,

With specials gate, 

Mur gate,

false and unnecessary minor ailments claims,

over ordering repeat items, and claiming for undispensed & uncollected items,

Putting back uncollected items and claiming for them (Particularly for exempt Pateints)

Time for NHS fraud teams to wake up and brings the culprits to task.

Valentine Trodd, Community pharmacist

Well, B**ts is the biggest pharmacy chain in the UK... and they certainly can't be trusted!

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