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NHS BSA recovers £45k in hypertension fees from a single pharmacy

NHS BSA recovers £45k in hypertension fees from a single pharmacy

Exclusive: The NHS Business Services Authority has recovered over £170,000 from nine pharmacies for inappropriate claims for hypertension checking consultations, P3pharmacy can reveal – including a clawback of over £45,000 from just one pharmacy.

Data released under the Freedom of Information Act shows that since the NHSBSA launched a post-payment verification (PPV) exercise in October 2023, a total of £172,858.36 has been clawed back from pharmacies delivering the Community Pharmacy Hypertension Case-Finding Advanced Service.

The NHSBSA declined to name the pharmacies when asked, but did reveal the amounts reclaimed and the date monies were clawed back, with the highest sum of £45,360 claimed back from one pharmacy on August 30, 2024.

Clawbacks have been ongoing since last spring with May 2024 seeing £26,415 and £37,990 reclaimed from two pharmacies respectively, while in August 2024 there were also clawbacks of £33,700 and £1,560.

The PPV exercise is still active, with clawbacks of £11,411, £3,635 and £9,276.68 taking place in January this year.

Pharmacies providing this service can claim £15 for every patient who receives a clinic blood pressure check and £45 for the provision of ambulatory blood pressure monitoring (ABPM) where this is clinically indicated. 

When the PPV was first announced, the NHSBSA said it would be targeting the NHSBSA said it was targeting both pharmacies with unusually high numbers of claims and those carrying out high numbers of initial checks but providing “disproportionately fewer” patients with APBM, as well as those reporting significant numbers of patients with “very high” blood pressure readings.

A large discrepancy between the number of clinical blood pressure checks and ABPM checks has been a feature of the service since it launched in 2021. In November 2024, pharmacies provided 250,051 hypertension checks and 20,467 ABPM checks.

The NHSBSA told P3pharmacy it has challenged a total of 32 pharmacies to provide evidence backing up their fee claims, and that despite nine businesses having to hand back large sums to the NHS none have been stopped from providing the hypertension service.

An NHSBSA spokesperson commented: “Contractors must submit their claims in accordance with the Drug Tariff and NHS England's service specification for the NHS community pharmacy hypertension case-finding advanced service.

“As per NHS England's service specification, necessary evidence must be kept for at least three years. A potential outcome of any assurance activity is the recovery of money already paid if a pharmacy contractor is unable to provide evidence to support their claims.”

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