All cases dealt with by the national health service counter fraud service (CFS) have the potential to result in criminal prosecution. The CFS also seeks civil recovery of losses to the NHS and investigation costs, as well as disciplinary sanctions before the appropriate regulatory or disciplinary body.
No pharmaceutical appliance contractors have been prosecuted in relation to dispensing or multiple licences in the last five years.
(2) how many (a) industry representatives, (b) patient groups and (c) NHS organisations responded to the June 2008 consultation on changes to Part IX of the Drug Tariff; and what plans he has to publish the results of the consultation;
(3) what assessment he has made of the advantages and disadvantages for dispensing appliance contractors with multiple dispensing licences under (a) the current on-cost system and (b) the system of remuneration proposed by his Department in its consultation on the provision of appliances under Part IX of the Drug Tariff;
(4) pursuant to the answer of 6 October 2008, Official Report, column 434W, on incontinence: medical equipment, for what reason it is proposed to cap the infrastructure payment for Part IX-related services at 50,000 prescription items;
(5) pursuant to the answer of 6 October 2008, Official Report, column 434W, on incontinence: medical equipment, how many respondents to his Department’s previous consultations on his Department’s proposals for provision of stoma and incontinence appliances under Part IX of the Drug Tariff (a) requested a cap at 50,000 prescription items and (b) advocated the removal of any cap.
In addition to a number of proposals relating to payment by way of fees for specific services which patients will receive directly—such as home delivery—the Department’s latest consultation “Proposed new arrangement under Part IX for the provision of stoma and urology appliances and related services in primary care” (which has already been placed in the Library) proposed an infrastructure payment which is designed to cover requirements that are not directly linked to dispensing a prescription item for instance, operating within a clinical governance framework. It was proposed that the payment should be banded and capped according to the number of stoma and urology items dispensed on a monthly basis. The highest band was 30,000-50,000 items and two dispensing appliance contractors dispense more than 50,000 prescription items per month. The Department is now analysing responses to the consultation, including views on the proposed cap to the infrastructure payment.
About 450,000 people use stoma and urology appliances. Under the current arrangements that primary care trusts have with dispensing appliance contractors (DACs) there is no requirement for them to provide patient numbers. However, in responding to the Department’s latest proposals some DACs have provided specific numbers in support of their views.
Responses to the June consultation were received from:
41 industry representatives
13 patient groups
27 NHS organisations
Control of entry was outside the scope of the June consultation. However, some assessment of the implications of the proposed remuneration system for appliance contractors with multiple dispensing licences has been made in the impact assessment—small firms sections—to illustrate the impact of different licence arrangements on the different possible remunerations (pages 26, 27).
In the September 2007 consultation, the infrastructure payment cap was set at 35,000 part IX items dispensed per month. This cap was raised to 50,000 items per month in the June 2008 consultation.
The proposal took account of views expressed by interested parties in response to the September 2007 consultation that:
the level of infrastructure payment proposed could disrupt ongoing patient care;
the banded structure for the infrastructure payment would affect individual contractors in a different way, inadvertently favouring some providers over others; and
the volume cap proposed was too low and disadvantaged companies dispensing a high number of part IX prescription items to an excessive extent.
Views were sought on the new proposals and the Department is in the process of analysing responses.
140 responses were received to the September 2007 consultation. Of these:
none requested a cap of 50,000 prescription items; and
two respondents advocated the removal of the cap.