Claims – Locum, Reimbursement, CBS

The ICB has recently written to practices regarding claims and as we near the end of the current financial year, to ensure all claims are submitted and processed appropriately, please find attached Practice Claims Schedule for the financial year 2024/25 for your reference.

Please take the time to review this as it explains where to submit claims for services and shows the deadlines for claiming as well as contact details for any queries.

Practices are encouraged to submit claims in a timely manner (ideally within the financial year of the activity completed) to support with practice finances and cashflow.  If a practice needs to invoice the ICB then please ensure that the instructions in the attached ‘Good Invoice Guide’ have been followed.  This will ensure that delays in the processing of invoices will be reduced.

It is important that practices claim on a timely to support cashflow within the practice. The following forms included in this update:

• LOC1 Sickness form
• LOC4 Maternity form
• LOC5 Paternity form
• LOC6 General claim form
• Practice Claims Schedule for the financial year 2024/25

Sickness/Locum/Maternity/Paternity Claims

GPC has announced the agreed changes to maternity leave changes – https://www.llrlmc.co.uk/news/maternity-leave-changes/

Maternity

Locum reimbursement to cover maternity leave.  Please complete and return to nnicb-nn.eastmidlands-pcgp@nhs.net with a copy of the following:

• Copy of the relevant page of the employment contract or partnership agreement which confirms the length of time the GP will receive full pay during their maternity leave.  
• MATB1 Form 
• A letter from the GP stating when they plan to start Maternity Leave. 

You are entitled to claim support for a maximum of 26 weeks to cover maternity leave. 

Also, enclosed is a LOC6 form to be completed in full and returned to nnicb-nn.eastmidlands-pcgp@nhs.net with the relevant supporting documents (i.e. invoices for the period of the claim). 

Please ensure that the Invoice Weekly Breakdown tab within the LOC6 form is completed.  The sessions completed per GP providing cover along with the invoice amount or salary paid to the GP providing the cover must be entered in the relevant section.

LOC6 forms should be returned monthly using a separate claim form for each absent GP.

   

Paternity

Locum reimbursement to cover paternity leave. Please complete and return to nnicb-nn.eastmidlands-pcgp@nhs.net with a copy of the following

• Copy of the relevant page of the employment contract or partnership agreement which confirms that the GP will be paid their full salary for the duration of the leave.

• MATB1 Form.
• A letter from the GP stating when they plan to start Paternity Leave.

You are entitled to claim support for a maximum of 2 weeks at a maximum of £1211.64 per week.

Please complete and return the attached LOC5 application Form.

Please ensure that the Invoice Weekly Breakdown tab within the LOC6 form is completed. 

The sessions completed per GP providing cover along with the invoice mount or salary paid to the GP providing the cover must be entered in the relevant section.

Sickness

Locum reimbursement to cover sick leave (LOC1).  Please complete and return to nnicb-nn.eastmidlands-pcgp@nhs.net a copy of the following:

• The sick note for the period of absence confirming the first day of sick leave
• Confirmation of sick leave taken in the last 52 weeks
• Confirmation of the sickness entitlement

For a salaried GP – extract from the contract stating sick pay entitlement.

For a partner – extract from the partnership agreement stating drawing during sickness.

Attached LOC1 and LOC6 form to be completed in full and returned with the relevant supporting documents (i.e. invoices for the period of the claim and copies of sicknotes). 

  

Please ensure that the Invoice Weekly Breakdown tab within the LOC6 form is completed.  The sessions completed per GP providing cover along with the invoice amount or salary paid to the GP providing the cover must be entered in the relevant section. 

  

LOC6 forms should be returned monthly using a separate claim form for each absent GP.  

  

You are entitled to claim support for a maximum of 26 week at the full rate and 26 week at the half rate within a 12 month rolling period.  The entitlement begins after the first 2 weeks of sickness. he first 2 weeks of sickness. 

For any invoice submitted to the ICB, please ensure the following information is included:

NHS Leicester, Leicestershire & Rutland ICB

QK1 Payables N235

PO Box 312

LEEDS

LS11 1HP

(Please note, any invoice submitted to sbs.apinvoicing@nhs.net without the above information will be rejected by the system – the system does not generate notifications for rejected invoices).

QOF (CQRS)

Please see attached email relating to QOF actions with deadlines for actions to be completed – the email attached provides links to guidance to support you through the steps needed to ensure accurate calculations for QOF achievement and aspiration payments.

Upcoming Claims

The claims window for the following services claimed via CQRS Local will open from 01^st April 2025 to 11^th April 2025:

• Community Based Services (CBS) 2024/25 – quarter 4 claim

Complex Care

Each practice has an annual cap for the number of complex care plans that they can claim for, please ensure you are only claiming upto the cap – any claims submitted above the cap will be rejected and providers will need to amend as necessary and resubmit (this can cause delay in approving claims and subsequently may result in delays in payments).

For practices who have not reached their cap, it is encouraged that they seek support from their PCN (payment arrangement for this would be between the practice and PCN, and not through the ICB).

• 48-hour Wheezy Children service (claimable subject to appropriate sign-up)

If your practice is unable to submit a claim by 11^th April 2025, please contact llricb-llr.primarycareteam@nhs.net as soon as possible – the claims window may be extended however this will result in payment being delayed to the following months statement. Please note that practices are able to claim for activity that has been carried out, but not claimed for, in previous quarters but a breakdown of the claim, showing the activity per quarter, should be provided by attaching a spreadsheet to the claim.