On 12 July our Primary Care Appeals service published its Factsheet 6 for 2022/23. This annual publication provides a clear statistical overview of the appeals and disputes cases, pertaining to primary care, managed by the service each financial year.
This year’s Factsheet 6
For the first time, Factsheet 6 for 2022/23 includes outcomes from pharmacy performance sanction and payment dispute cases, as well as all decisions relating to dental, medical and Performers Lists cases. Dispute category is listed for each of these cases, as is geographic area.
The data from Factsheet 6 for 2022/23 shows that Primary Care Appeals experienced a 34% increase in in new appeals and disputes compared to the previous year (please see Factsheet 6 for 2021/22). This was mostly due to the service receiving new Directions from the DHSC to manage Covid-19 pharmacy payment appeals, and partly due to a batch of other payment cases, such as Medicines Delivery Service (MDS) payment recovery disputes. Nonetheless, the service oversaw an 8% increase in cases brought to resolution in 2022/23, compared to the previous year. This was due to the increase in determinations resulting from the quick resolution of MDS cases.
Earlier Factsheets 6
You can find Factsheet 6 for earlier years on our website, in the Primary Care Appeals resources section. We have also provided some direct links below:
Email notification of primary care appeals decisions
It is also possible to sign-up to receive email notifications linked to our monthly publication of decisions in the primary care appeals and disputes we manage.
Factsheet 5
Please note, our Claims Management service, will publish its annual Factsheet 5 later in the year. This provides a statistical overview of the trust and health authority indemnity claims the service handled in 2022/23. Past years’ Factsheet 5 can be found on our website, including last year’s Factsheet 5 for 2021/22.
