DoctoriumGP · Practice MOT
Practice MOT
The method

How a Practice MOT actually works.

No magic and no black box. We don't take a copy of your data, and nothing leaves your clinical system. We find the places where your own record contradicts itself — and every one is either a patient missing the care they should have, income you've earned but never claimed, or both.

01 · Detection

How we tell something's been miscoded

The Funding Radar is a map, not a scanner

Start with what the Radar is not. It doesn't look at a single patient record. It's a structured map of every income stream a practice in your area can legitimately claim — national contract, PCN, your ICB's local and enhanced services, and the council's public-health contracts — with the rules and deadlines attached. It tells us where money is claimable. Finding the actual under-claimed activity is a separate job, done inside your system.

Detection runs inside your own clinical system

The searches run in your own clinical system — EMIS or SystmOne — on your premises (or under your supervision on a secure screen-share), using Ardens — the same searches thousands of practices already use. They're built directly on the published QOF Business Rules and the official SNOMED CT code clusters, so they ask exactly the questions the contract asks. We're not inventing a definition of "diabetic" — we're using the NHS's own.

What the searches look for: internal contradictions

The whole method rests on one idea. A clinically coherent record is internally consistent. Where it isn't, something has usually been missed at the point of coding. We surface three kinds of contradiction:

Contradiction 1

A drug with no diagnosis

A patient on metformin with no diabetes code; on a DMARD with no inflammatory-arthritis code. The treatment is real and recorded — the diagnosis code that should sit beside it is missing.

Contradiction 2

A result with no diagnosis

Repeated HbA1c results in the diabetic range with no register code; an eGFR consistent with CKD never coded; BPs in the hypertensive range with no hypertension code.

Contradiction 3

Activity with no claim

Vaccinations given and recorded but not extracting for payment because of a missing or wrong code; LD health checks done in clinic but never appearing in CQRS.

Prevalence benchmarking tells us where to dig

Alongside the contradiction searches, we compare your recorded prevalence on each major register — diabetes, CVD, hypertension, AF, COPD — against your Sub-ICB and England averages, using the public NHS Digital QOF database at qof.digital.nhs.uk. A register sitting materially below the expected level is a flag: it points us at exactly which registers to interrogate first. It doesn't prove anything alone — it tells us where the under-coding is most likely hiding.

The search only produces a worklist — a clinician decides

This is the part that matters most, and the part we won't cut corners on. Every search produces nothing more than a worklist of named candidate patients: "here are the people whose record suggests a code may be missing." That list is reviewed by a clinician, patient by patient, who confirms or rejects every single one against the actual record.

Accuracy, never inflation. We code for accuracy, never to inflate a register. Padding a register with patients who don't genuinely meet the criteria isn't a clever trick — it's a clawback risk and, at worst, fraud. The point is the opposite: to make the register true. A code goes on only when a clinician agrees the evidence supports it.

What a confirmed code actually does

When a clinician confirms a genuinely missing code, four things happen at once, all pulling the same way: the disease register becomes more accurate; your recorded prevalence rises toward the true figure; the QOF and contract income that was always earned but never captured can now be claimed; and the patient is correctly identified for recall, monitoring and the care that goes with their condition. Better care and recovered income aren't in tension — they're the same act of getting the record right. And throughout, the data never leaves your clinical system.

02 · Methodology

Who we ask, and exactly what we gather

The audit is deliberately concrete. We talk to the people who actually run the practice and pull the reports that actually drive payment, then reconcile one against the other. Nothing depends on taking our word for it — every figure traces back to a report you can pull yourself.

Who we interview, and what we ask

The Practice / Business Manager — the main session

The longest conversation, because this is where income and claiming live:

The GP partners

A short session on the strategic picture: where you lose time off-the-ball, whether you have clear sight of where the money comes from and goes, services you'd like to offer but don't, and what a good result looks like to you.

The practice nurse / HCA lead

Which clinics run and which could run but don't; how long-term-condition patients are recalled and who chases non-responders; who codes the vaccinations and reviews, and whether coding ever gets missed.

The clinical pharmacist / PA

The repeat-prescription process and eRD uptake; whether structured medication reviews are done and coded so they count; and whether shared-care drug monitoring (DMARDs, lithium, amiodarone) is claimed under a local service.

The reception / care-navigation lead

Call volumes and peak times; how much demand is patients chasing — results not communicated, scripts not ready, referrals not booked; what a patient can self-book versus what forces a phone call; and how documents and results get handled and coded.

The accountant

Whether they're an AISMA specialist medical firm or a general accountant; whether the NHS pension and superannuation position is optimised; whether partner expense claims and capital allowances are fully made. A generalist accountant is, in itself, a flag worth acting on.

What we gather and reconcile

The interviews tell us how the practice thinks it runs. The reports tell us how it actually runs. All of it inside your system or from your own statements:

From EMIS

From Ardens

From CQRS & CQRS Local

From PCSE Online

How it comes together

Every income line ends up in a single, plain table: what's currently claimed (from your statements), against what's eligible (from EMIS and Ardens), with the gap between them shown explicitly. Prevalence shortfalls, expired CQRS Local claims, uncoded vaccinations, missed enhanced services — each a defined, traceable, reviewable line. You see precisely where the number comes from, and if there's little to find, we tell you that plainly.

03 · From day one

Exactly what happens, week by week

A clear, bounded engagement — remote-first, no patient data leaves your building, and the audit itself is free. Here's precisely who does what, and what we need from you.

0
Days 1–3 · before any data is touched

Set-up & governance

We stand the engagement up on a clean, arm's-length footing so there's nothing to worry about on information governance.

We do

  • Engagement letter + Data Processing Agreement (PHW Ltd)
  • Author the DPIA for the work
  • Confirm PI/PL insurance + clinical-safety sign-off
  • Send the one-page data request

You provide

  • A signed engagement letter + DPA
  • A named contact (PM) and a clinical sponsor
  • Confirmation your DSPT is current
  • The agreed in-system access on agreed days
1
Week 1 · a 30-minute call

Kickoff & data request

A short scoping call to agree the plan and book the findings session. We send a single one-page data request — nothing to chase down in advance.

We do

  • Run the kickoff, scope the work, book the findings meeting
  • Confirm whether your team runs the searches or we run them under supervision

You provide

  • Attendance at the 30-minute kickoff (PM + clinical sponsor)
  • ~2–3 hours of admin time to pull the data pack: list size, QOF achievement + prevalence, service sign-ups, one quarter of CQRS/PCSE statements, a staff-time snapshot and tool stack
2
Weeks 1–3 · ~2.5 days of our analysis

The audit sweep

The MOT itself — four review lenses worked methodically, remote-first or in-system, so no patient data leaves the building: Income (QOF coding + the Funding Radar vs your statements), Efficiency (process-mapping + reclaimable time + the right NHS-approved tools), Workforce (activity data + ARRS utilisation), and Compliance (the free CQC searches as a posture check).

We do

  • Run all four lenses and build the findings report on your real numbers
  • Bring in a clinical-coding specialist where needed

You provide

  • Practical access on the agreed days
  • A clinician for ~1–2 hours to validate the coding worklist
3
Weeks 2–3 · a 45–60 minute partner meeting

Findings handed over

We sit with the partners and walk you through your real, bounded numbers — recoverable income, reclaimable time, the workforce picture and CQC notes — alongside a prioritised action list. If there's little to find, we say so.

We do

  • Present the findings + prioritised actions
  • Set out the two ways to proceed, no pressure

You provide

  • Partner attendance
  • A decision on which fixes to action
4
Weeks 3–12 · the setup sprint, if you proceed

Recovery & automation

We action the genuine wins with you — recovering income inside its claim windows and standing up automation, free and NHS-funded tools first.

We do

  • Action recovery: clinician-approved code corrections + missed claims submitted in-window
  • Stand up agreed automations — configure, integrate, author each DPIA, train staff
  • Populate the SOP library + workload tracker, re-measure vs baseline

You provide

  • Clinician sign-off on every register correction — you always own the record
  • Admin time to submit claims and adopt one or two automations
5
Month 12 onwards · light once set up

Ongoing monitoring

We keep watch on the sources that move money — and the deadlines that lose it — so there's no March panic and no missed claim window.

We do

  • Monitor SFE, NHSE, BMA, LMC, ICB and council sources for new or repriced funding, and alert you
  • Track claim deadlines, keep QOF tracking against thresholds, hold a 30-minute quarterly review

You provide

  • ~30 minutes a quarter for the partnership review

How the free pilot works

The MOT carries no cost for early adopters — the full four-lens audit, the findings report and the partner meeting, all before any money changes hands. We work in-system so no patient data leaves the building, every clinical code is validated by your own clinician, and the engagement is contracted arm's-length through PHW Ltd. Find little, and we tell you plainly and you walk away owing nothing. Find real money, and you choose how to proceed.