FOI-03463

__Request__

_I am writing to request information under the Freedom of Information Act 2000 relating to General Ophthalmic Services (GOS) post-payment verification._ 
 
_For the period 1 April 2021 to 31 March 2025 (or the most recent year for which data is available), please provide:_ 
 
•	_The total monetary value (£) recovered nationally as a result of post-payment verification activity relating to GOS claims._
 
•	_A financial year-by-year breakdown of the total recoveries for each year within this period._

•	_The total number of post-payment verification reviews undertaken in each financial year._
 
•	_The number of providers subject to recovery action in each financial year._
 
•	_Where held, a breakdown of recovery totals by provider category, for example independent practices versus large multiples, provided that no individual provider is identifiable._
 
•	_Any summary statistics held, such as average or median recovery amounts per case._
 
_Additionally:_
 
_Please confirm whether recovery data is held at an individual provider level (e.g. for named national optical multiples), and if so, whether any of this information can be disclosed in anonymised, aggregated, or banded form._
 
_I am content for the information to be provided in aggregated or anonymised form where necessary to comply with the Act and its exemptions._
 
_If any part of this request exceeds the cost limit under Section 12, please provide advice and assistance under Section 16 to refine the request._ 

__Response__

I can confirm that the NHSBSA holds some of the information you have requested. 
 
Please read the below notes to ensure correct understanding of the data. 
 
__Q1. The total monetary value (£) recovered nationally as a result of post-payment verification activity relating to GOS claims.__ 
 
£457,144.60 
 
__Q2. A financial year-by-year breakdown of the total recoveries for each year within this period.__ 
 
2021–2022: £39,026.32 
 
2022–2023: £5,655.97 
 
2023–2024: £106,815.20 
 
2024–2025: £305,647.11 
 
__Q3. The total number of post-payment verification reviews undertaken in each financial year.__ 
 
2021–2022: 11 
 
2022–2023: 56 
 
2023–2024: 54 
 
2024–2025: 117 
 
__Q4. The number of providers subject to recovery action in each financial year.__ 
 
2021–2022: 181 
 
2022–2023: 16 
 
2023–2024: 44 
 
2024–2025: 103 
 
__Q5. Breakdown of recovery totals by provider category (independent practices vs large multiples).__ 

Please see a copy of the information attached.
 
 
__Q6. Any summary statistics held, such as average or median recovery amounts per case__ 
 
I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA. 
 
__Guidance Notes__ 
 
•	The data provided has been extracted from our Case Management System (CMS). 

•	PPV refers to Post Payment Verification exercises, which were undertaken by NHS Business Services Authority (NHSBSA) on behalf of NHS England (NHSE) and Integrated Care Boards (ICBs). 

•	The NHSBSA does not process recoveries directly; recoveries are submitted via a Deduction Form to Commissioning Teams for action. 

•	Recoveries are grouped by the date the Deduction Forms were sent to Commissioning Teams and are made against the contractor, not at provider level. 

•	The number of PPV reviews undertaken within each financial year is based on the date the evidence for the case was requested. 

•	Regular PPV sampling was suspended from March 2020 until February 2023. 

•	Figures for 2021–2022 are lower because the NHSBSA was directed to prioritise other work by NHSE and to close PPV cases started prior to March 2020. 

•	Within our CMS, an independent contractor is defined as having only one optical site. Contractors with more than one optical site are classed as multiples. 
 
__Data Queries__
 
Please contact foirequests@nhsbsa.nhs.uk ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data. 

__Reusing the data and copyright__
 
If you plan on producing a press or broadcast story based upon the data, please contact communicationsteam@nhsbsa.nhs.uk. This is important to ensure that the figures are not misunderstood or misrepresented. 
 
The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at: 
 
http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/  
 
Should you wish to re-use the information you must include the following statement: “NHSBSA Copyright 2026”. Failure to do so is a breach of the terms of the licence. 
 
Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information. 


Tags: gos, post-payment verification
Organization: Freedom of Information Disclosure Log