OFNC responds to new NHSBSA Post Payment Verification guidance

The statement includes advice for providers and clinicians

patient and volk
Pixabay/Paul Diaconu

The Optometric Fees Negotiating Committee (OFNC) has released a statement in response to new guidance from NHS England and NHS Business Services Authority (BSA) on Post Payment Verification (PPV) for General Ophthalmic Services (GOS).

The NHSBSA said the new guidance aims to standardise the PPV process nationally, and will result in a risk-based and targeted approach to selecting contractors for PPV sampling, with a focus on a smaller number of practices but reviewing a larger number of claims at each.

Contractors will receive local and national benchmarking data, to enable them to see how they compare with peers on some key data metrics.

The OFNC highlighted that it was consulted at a late point in the development process, and worked to ensure the guidance takes “a sensible and evidence-based approach,” such as looking to understand outliers, rather than “assuming something must be wrong.”

It also worked to ensure the guidance is clear that, if the PPV process discovers underpayments, these are paid to the contractor, and that the guidance is carefully monitored during implementation to ensure any issues are addressed quickly.

“We know that in the past, PPV processes have not always been well implemented and at points based upon flawed logic,” the OFNC statement reads. “This has increased costs for practices, delivering no benefit for the NHS and have also in some instances reduced patient access.”

The NHSBSA said the new guidance aims to be “fair, consistent and proportionate,” delivering “improved value for money and quality.”

The OFNC noted that the cost and time associated with PPV is a challenge for all contractors, advising all providers and clinicians to ensure record cards “clearly show why any early retest was necessary” and that, where a dispensing supplement has been claimed, “the clinical reason for prescribing is clearly defined and easy to find on the record.”

The AOP has encouraged any members with questions about PPV to contact the regulatory team.