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Maximise your income for Personally Administered Items (PAIs)

  • 18th July 2016

Maximise your income for Personally Administered Items (PAIs)

A guest blog by Tracy Hole, The Surgery Network.

Many practices are losing thousands of pounds a year by not getting the full income they are due for Personally Administered Items. Guest blogger Tracy Hols demystifies this complex process and provides hints and tips to help surgeries maximise their income.

Complex processes involved in purchasing and managing Personally Administered Items (PAIs), and then claiming for them from Prescription Services (formally the PPA) means it is extremely difficult for GP practices to know if they are maximising their income.

Practices submit their FP34D returns each month based on the prescriptions raised, but it is very difficult to know what is claimable and whether all the eligible items used have been given a prescription.

Often claimable items are not included because it is thought that it is not worth raising the paperwork, or the items are not bought at all because of concerns over their high cost - for example cancer drugs.

And not filling in the forms correctly can cost the surgery money through reduced dispencing fees.

All of these issues can compound together to create a significant shortfall in income for many GPs.

So here are our simple tips that can help make a big difference:

 

1. Make sure you what is claimable! You can claim for:

- Vaccines, anaesthetics, injections

- Pessaries

- IUCDs (including diaphrams)

- Diagnostic Reagents

- Sutures, but not all are claimable - check carefully

- You can find the list of claimable items atwww.dmd.medicines.org.uk

 

2. Conduct an end-to-end review

Once you know what to look for, go through your historic invoices to quantify all the PAIs you buy and compare this with the prescriptions raised and income received.  This will tell you how much income you have under-claimed.

 

3. Ensure everyone knows what is claimable

- Choose someone to maintain an end-to-end view

- Communicatre the list of items to clinicians

- Identify claimable items when they are ordered and then track them through the surgery using visual cues and signs to remind everyone.

 

4. Raise prescriptions for every claimable item

Do this no matter how low the cost as the dispencing fees quickly add up.

 

5. Purchase cancer drugs, rather than issuing a prescription to the patient

Drugs such as Zoladex, Prostap and Decapapyl will earn the practice a profit of around £170 per patient per year. For example, a 6,000 patient surgery will have around 6 patients resulting in a profit of over £1,000.

 

6. Ensuring nothing is missed on the FP34D

When raising the FP34D, check the list of prescriptions against the list of items purchased and used. if there is a big difference each month, then this means that prescriptions have not been raised so further communications and training may be required.

 

7. Ensure you get the full dispencing fee for every item

The dispencing fee is reduced when more than 455 items are allocated to one GP in one month. Therefore during the flu season enter 'Influenza' seperately for each responsible GP and ensure no one GP has more than 455 items.

 

8. Check your Open Exeter payment

Keep a record of claims and the income you expect to receive. Check the payments for individual GPs. Log in to Open Exeter and go to 'Drug Payments'.

 

9. Work with your specialist medical accountant to understand your PAI profit

The Surgery Network has developed a 'PPA Health Check' for non-dispencing practices.  Using the graph, look up your 'Traget PAI profit per patient' Then speak to your accountant to obtain the actual PAI profit from your accounts and compare the two.  If there is a significant shortfall then you should investigate further.

Our Guest Author

Tracy Hole

Director, The Surgery Network
  • Very smooth changeover to BW, with good communication at all times. Very efficient in the production of the accounts (as promised) and the Partners are delighted with the advice received to date.

    Paul Atkinson, Practice Manager
    Netherfield House Surgery, Northumberland
  • BW Medical Accountants have a good working knowledge of General Practice and are keenly aware of the challenges Practices face within the changing environment of the NHS.  Benfield Park have been very impressed by the way BW Medical continue to deliver the range of services they provide from Accounts to Tax and NHS Pension advice. 

    We have found Practice consultation and engagement from BW Medical specifically helpful to shape the future of the Practice.

    Jonathan McCutcheon, Practice Manager
    Benfield Park Medical Group, Newcastle
  • We had no hesitation in moving to BW Medical Accountants.  For any business your accountant is integral, and for us one of the most important factors to this relationship is to have a personal and trusting approach, which BW have undoubtedly achieved. 

    The service we receive and the interest they show in our practice assures us that they have a genuine interest in us and commitment to us.  More importantly they are always helpful and polite to answer even the dumbest of questions!  They give us confidence and reassurance knowing that they are always very up-to-date with all the numerous changes within general practice and we would have no hesitation in recommending them to other practices seeking a professional and personal accountancy service.

    Jackie Rotherham, Practice Manager
    The James Street Family Practice, Lincolnshire
  • We moved to BW Medical Accountants in 2013 and we are delighted that we have.  Having been in the same business for over 20 years it is important to have a relationship with the accountancy team but most importantly you need to have trust.  We made the decision to move our business to BW Medical Accountants and having worked with the Team especially Tina we are very satisfied.  Tina going through the accounts brought to our attention many things that I was not aware of in the past.  The first years' experience can only be described as excellent.

    Customer service is first and foremost with BW and this shines through as each and every one of them are approachable, helpful and most importantly understand and know the business.  General practice is complex and is going to get more complex in the coming years.  We need Accountants who truly understand our business. We as a practice and as individuals would certainly recommend BW Medical Accountants.

    Gloria Middleton, Managing Partner
    Westbourne Medical Group, Sunderland
  • We changed to BW Medical Accountants during this financial year and I would say we have just had the most transparent and understandable end of year meeting and the best planning advice I have ever had in 16 years of practice.

    Dr H Jervis, Partner
    Temple Sowerby Medical Practice, Cumbria

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