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Standard capitation fees are paid at three rates according to the patient's age on the last day of the preceding quarter:
• under 65 years
• 65 to 74 years
• 75 years and over.
Fees are paid quarterly at one quarter of the annual rate. (Capitation fees for child health surveillance and deprivation are also paid quarterly at one quarter of the annual rate.)
The calculation of lists is described in paragraph 73 of the Red Book. As soon as possible after the beginning of each quarter, the health authority tells GPs the numbers of:
• patients in each of the three age groups
• children for whom they have agreed to provide child health surveillance
• patients for whom a deprivation payment is due, in each group, and the level of fee they attract
• patients for whom a rural practice payment is due.
If the health authority is told that a patient has joined a GP's list within 48 hours of the start of a quarter, and it is satisfied that the patient was accepted on or before the first day of the quarter, the patient will be included in the count of patients on the first day of the quarter. Every GP should send patient acceptances to the health authority as soon as possible, in order to increase the accuracy of the count at the start of the quarter, and to speed up transfer of medical records between practices.
How to challenge a health authority's estimate of list size
Any GP wishing to challenge the count of patients must tell the health authority within 10 days of being sent this information. Objections cannot be made after this 10 day period. Having given notice of a challenge, the GP should send the health authority, within 21 days of receiving the original information, any evidence reasonably required to settle the dispute.
Box 10.1: Challenging a health authority's estimate of list size
• notice of challenge must be submitted within 10 days of receiving notification of list size
• the onus is on the GP to submit evidence to challenge the health authority's figures, within 21 days of being notified of list size
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| Book Title: Making Sense of The Red Book | ||