NHS England is in the process of reviewing its primary care contractors’ contributions for providing out-of-hours services in a bid to ensure that there is an ‘equitable methodology in deduction across all practices and that GP practices are not being over or under charged’.

This means that almost 400 practices across London have received letters advising them of the correct level of deduction for their decision to opt out of out-of-hours provision, after ‘differing approaches’ by Primary Care Trusts (PCTs) led to practices being paid inconsistently.

One letter sent by the local area team told a practice it had to make a payment of £18,700 over the next 12 months but a spokesman for the team claimed that it was only clawing back over-deductions over the past financial year after inheriting the payment systems from PCTs and that some practices will get money back for under-deductions.

The letter explains that, previously, each borough was using a different methodology to calculate the deductions and that the new approach will standardise the system across London.

It adds: ‘In your case the difference is -£18,700.97. If this figure is negative you owe money to NHS England and if it is positive NHS England owes you money.’

However, London Local Medical Committee (LMC) leaders have questioned the methodology of the approach, with a spokesman saying that he has not seen the calculations that NHS England has made to compare with the calculations that PCTs have made.

He added that the NHS England letter claimed that the methodology was discussed and approved by the LMC in October 2013 but that this was not the case, so the committee is now seeking clarification.