An NHS administrative error led to 16 GP surgeries mistakenly being paid hundreds of thousands of pounds.
The practices in Nottinghamshire were given money for providing out-of-hours care, but when they opted out of it, they continued to be paid.
Now health bosses are trying to reclaim the money, which was mistakenly paid over a three-and-a-half-year period.
Affected GPs said there was no way they could have known they were getting too much money – and had already spent it.
Meanwhile, the Nottingham and Nottinghamshire integrated care board (ICB) said it had a duty to correctly allocate money.
The ICB said the surgeries that opted out of providing care should have had their budgets reduced by 4.75% as a result of the change, but continued to receive the same level of funding until the error was detected in October.
Michael Wright, the chief executive of the Nottinghamshire Local Medical Council (LMC) – which represents the affected surgeries – said practices had been told they must pay back sums between £20,000 and £300,000.
“It’s a very difficult situation,” Mr Wright said. “This was, put simply, an admin blunder by the ICB.
“The surgeries had expected the ICB to adjust their funding when they ceased out-of-hours care, but that did not happen.
“They, of course, recognise now the ICB wants the money back and that they should not have received it in the first place.
“However, it was not unreasonable of them to spend what they were given – and they spent it on patient care.
“Paying it back will now have an impact on patient care in the future. We think the ICB, which made the mistake, should own it and write the sums off.”
Mr Wright said one of the surgeries affected was the Windmill Practice in Sneinton, Nottingham, which owed £174,000.
The practice, which has been contacted for comment, has decided to end its contract with the ICB from June.
He added: “The clawback of the money is not the only reason Windmill is handing its contract back, but the situation has not helped.
“GP surgeries are underfunded and under pressure and the worst case scenario is the clawback of this money is what prompts some of them to call it a day.”
The Tudor House Medical Practice, in Sherwood, Nottingham, has been told it owes £108,000 to the ICB.
The surgery said it would remain open, but practice manager Patricia Gibbons told the BBC: “There was no way we could have known the ICB was not paying us the right amount.
“We spent that money on patient care, it didn’t get blown on fast cars and fancy flats. It went on costs like paying staff, dealing with rising utility bills, and looking after our patients.”
Dr Jonathan Lloyd, from the practice, said: “The ICB made the mistake and has acknowledged there was nothing we could have done to avoid this.
“Contractually they can require money back but morally, it’s questionable – and illogical.”
The ICB has declined to reveal the total sum owed by the practices, or elaborate on how the error was made.
A spokesperson said: “We are in discussions with specific individual GP practices in Nottingham and Nottinghamshire relating to the repayment of monies back to the ICB that were paid to them in error, for services which they did not provide.
“In all cases, the situation arose following changes made in contractual status and the contract payment mechanism not being adjusted to reflect the change.
“We very much regret the impact that this may have had on practices operating as independent businesses.
“However, this is the public’s money and we have a duty to ensure it is allocated correctly.
“To minimise the impact on those affected practices, we are speaking with them on a one-to-one basis to agree the best way for them to repay over an agreed period.”
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