A recent dispute resolution case, decided by NHS Resolution, serves as a sobering reminder for General Practice teams: even when the work is done, payment is never guaranteed unless every step of the contract is followed to the letter.
The case involved a practice that had successfully delivered nearly 600 COVID-19 vaccinations during the 2024/25 programme. However, the associated claim—worth around £4,500—was rejected. The reason? The data wasn’t entered into the Point of Care system within the 15-day window specified in the Enhanced Service Specification. Despite well-documented staffing pressures and a clear statement from the practice that the work had been done and later recorded, the Commissioner declined payment. NHS Resolution upheld the decision, concluding that while the situation was unfortunate, the specification had been clear—and binding.
There’s an important message here for all practices: dispute resolution is possible, but outcomes are typically grounded in the black-and-white reading of contractual obligations. Sympathy, context, and effort are rarely enough to change the outcome when the contract says otherwise.
This isn’t an isolated risk. The Advice and Guidance DES, for example, has its own critical timeline—activity must be claimed by the 12th of the month following the date of the activity. Miss it, and the work goes unpaid. These short windows can be particularly harsh in overstretched practices juggling flu campaigns, long-term condition reviews, and the constant reality of staff shortages.
Yet not all claims are equal in terms of deadlines. Prescription Pricing Authority (PPA) claims have a window of up to six years, meaning older unclaimed income might still be recoverable. At Enhanced Technology, our GP Profit Recovery service has been developed to help practices unearth these lost earnings—commission only, no risk, and no-win no-fee. We routinely identify thousands of pounds in unclaimed PPA reimbursements and other backdated entitlements that would otherwise be lost to time.
Looking ahead, it will be interesting to see whether the Integrated Care Boards (ICBs), as they assume commissioning responsibilities from the soon-to-be-defunct NHS England, take a more pragmatic approach to exceptional circumstances. However, given the even tighter budgetary constraints under which ICBs operate, I suspect any opportunity not to make a payment will be quickly seized upon.
The moral of the story? Know your deadlines. Know your contracts. And where recovery is still an option, take it—before the clock really does run out.
GP Profit Recovery: www.gppr.uk