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A branch of Kamsons Pharmacy in Surrey has had £3,780 in New Medicine Service claims clawed back by the NHS Business Services Authority after failing in its appeal against an initial proposed clawback of £1,456.

Speaking to P3pharmacy, the chain said it was “disappointed” with the decision and criticised delays in the NHSBSA’s investigation, as well as its decision to target historic claims rather than recent ones – factors it described as consuming “much time and effort for all parties”.  

The Kamsons branch, which is located in Jubilee Health Centre in Wallington, was first asked by the NHSBSA in October 2023 to provide evidence for NMS claims between April 2021 and March 2022 as part of a post-payment verification (PPV) exercise targeting pharmacies with high numbers of claims for the service. The branch had claimed for 1,374 consultations from April 2021-March 2022.

As the pharmacy had destroyed documents older than two years in line with its standard operating procedures, the BSA agreed to limit its investigation to the period November 2021-March 2022 and on October 18 2024 wrote to the company declaring its intention to recover £1,456. 

This amount related to 52 “unverified” NMA claims rather than the £3,360 for 120 claims the BSA had initially sought, with the October 18 letter explaining that the reduction was “largely due” to the company’s “continued engagement and collaboration” with the BSA’s provider assurance team. 

Concerns were raised that in some cases separate claims had been submitted for NMS consultations that appeared to have been carried out with the same patient on the same day, with a different set of prescribed medicines discussed on each occasion.

In another example, a patient had separate catch-up NMS consultations two months apart for medicines that had both been prescribed on the same day.

Kamsons – which accepted that five NMS claims were ‘duplicates’ but disputed the total amount sought – accused the BSA of “rubber stamping” a decision reached by its pharmacy services regulation committee (PSRC) instead of considering the evidence provided by the company – a claim the BSA rejected. 

The company also said there had been a five-month gap between submitting its evidence in November 2023 and receiving a response from the BSA investigators, during which time a pharmacist manager left the branch. 

Reconsidering the pharmacy’s evidence following an appeal brought by Kamsons, NHS Resolution’s head of appeals Jonathan Haley identified 155 duplicate claims, raising the amount to be recovered to £3,780 – a 160 per cent increase. 

“I consider that there is no other sensible way of interpreting the evidence provided,” said Mr Haley, commenting that he was obliged to adhere to the wording of the service specification and that a number of claims for catch-up NMS consultations did not conform to the regulations.  

Kamsons Pharmacy chief operating officer Chris Bland told P3pharmacy: “We are of course disappointed by the deduction that NHS Resolution have made. 

“This has been a frustrating and long-winded process with the NHSBSA initially asking for evidence dating back to April 2021 and then taking five months to respond after receiving the requested information. 

“In this time, the pharmacist manager at the time had moved away so making any queries far more difficult to resolve. 

“Our belief was that the evidence substantiated the overall number of NMS undertaken in the period. NHSBSA and NHS Resolution obviously disagreed. 

“Much time and effort, for all parties, could have been saved by ensuring that such evidence requests by the NHSBSA are for recent evidence rather than that dating back years.”