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Capital consequences

The consequences of repeated raids on capital funding have been “coming home to roost” for NHS trusts.

Barts Health Trust is among those worst affected by the squeeze on capital, and has cited “significantly higher” risks around fire, medical equipment, and IT vulnerabilities after a recent plea for loan support was turned down.

It needed £29m from the Department of Health and Social Care to complete its capital programme for the year, which covered “only essential items, but has been given just £12m.

It said this would be used to fund the “most pressing priorities”, including updates to IT systems.

Barts was one of the trusts worst affected by the WannaCry cyberattack last year.

Saffron Cordery, policy and strategy director at NHS Providers, said these problems have been common across the sector and added: “NHS Improvement and the Department of Health and Social Care are trying to keep within the spending limit and that’s where the cumulative impact of the capital to revenue transfers comes home to roost.

“There is a consequence to this and trusts absolutely need the money to address these pressing risks.”

HMRC puts CCGs under microscope

HM Revenue and Customs has been scrutinising potential attempts from clinical commissioning groups to minimise GPs’ tax paymentsHSJ has learned.

HMRC has been in recent “discussions” with several CCGs about whether GPs working for their governing body or council of members are paid on or off payroll.

This is due to concerns, first raised in 2016, that CCGs are paying GPs off payroll in order to minimise their tax liabilities, despite Treasury recommendations – made in 2012 – that board members should be on payroll.

Rosie Cooper, a member of the Commons health committee, last week said HMRC and the Treasury have commissioned a report into “how GPs are paid”.

A spokesman for the HMRC and the Treasury told HSJ they were not aware of the report mentioned by Ms Cooper.

However, Liverpool, Greater Huddersfield and South Lincolnshire CCGs have each said they are cooperating with HMRC on its inquiries into how CCGs pay their governing body member GPs.