Consultation outcome

Proposed changes to the statutory scheme to control the costs of branded health service medicines

Updated 10 March 2020

Executive summary

The Department of Health and Social Care proposes to update the payment percentages in the statutory scheme for branded medicine pricing (known as the ‘statutory scheme’). This consultation document seeks the views of industry on the proposed changes.

The statutory scheme is set out in legislation in The Branded Health Service Medicines (Costs) Regulations 2018 (the Regulations).

The Regulations oblige the department to conduct an annual review of the scheme against its objectives. We will be undertaking this review simultaneously to this consultation and will publish it alongside our response to this consultation.

As a first stage of our review, we have considered the current payment percentages for 2020 and 2021, and whether they should be amended. We consider that they should be and, as such, this consultation sets out our proposed payment percentages.

We intend to reduce the gap in payment percentages between the statutory and the voluntary schemes so that there continues to be broad commercial equivalence between the schemes. We will continue to keep the statutory scheme under review through the annual review mechanism, including considering the growth rate and payment percentages.

The proposed changes to the statutory scheme payment percentage are set out in chapter 3 of this consultation.

We propose to reduce the payment percentage in 2020 from 14.7% to 7.4%. However, this amendment will not be in force until 1 April 2020. In recognition of this, companies who made statutory scheme payments in the first quarter of 2020 (and therefore will have been subject to scheme payments at 14.7%) will instead be subject to a payment percentage of 5% for quarters 2 to 4 of 2020.

If, however, a company does not make payments in the first quarter, or joins the statutory scheme after the first quarter, they will be subject to 7.4% for quarters 2 to 4. We also propose the payment percentage for the whole of 2021, for all statutory scheme members, at 10.9%.

In proposing these changes, the government is also required to consider and consult on a number of specific areas such as The Public Sector Equality Duty and the Secretary of State’s duties as set out in the NHS Act 2006. Our assessment of the proposals in relation to these statutory requirements are set out in chapter 5, with additional information provided in the accompanying impact assessment.

The initial assessment of the statutory duties and requirements of the consultation concluded that our proposed changes will help to ensure that the Secretary of State can continue to deliver on the statutory duties and there may be benefits for the life sciences sector.

1. Introduction

Background: statutory scheme for branded medicines pricing

The statutory scheme acts as one of the 2 mechanisms alongside the 2019 Voluntary Scheme for Branded Medicine Pricing and Access (2019VS) to control the prices of branded medicines to the NHS. Companies that have opted not to join the 2019VS – a voluntary non-contractual agreement, which replaced the previous Pharmaceutical Price Regulation Scheme (PPRS 2014) between government and industry – are members of the statutory scheme. The 2019VS began on 1 January 2019 and will run until the end of 2023.

The statutory scheme was significantly updated in 2018 and then amended further from the beginning of 2019. The changes in 2018 were to move away from a system of price cuts to one where payments were made up of a percentage of the value of the branded health service medicines sales by the relevant manufacturer or company in addition to price controls.

The amendments to the scheme from the beginning of 2019 were to:

• change the payment percentages in the Regulations
• include all biological medicinal products (including biosimilars) within the scope of health service medicines captured by the payment mechanism, price controls and information requirements
• change the application of the payment system for sales of medicines supplied under a contract with a contracting authority based on a framework agreement or under a public contract.

The statutory scheme creates an environment where clinically and cost-effective medicines are supplied at an affordable price, in a way consistent with supporting both the life sciences sector (including research and development) and the broader economy. This is achieved through seeking to limit the growth in allowed sales of branded medicines, which is currently at 1.1% (nominal) per year. Payment percentages, the rate at which companies pay back to the department, are then set to try to ensure growth is controlled at that level each year.

The terms of the statutory scheme provide:

• application of a payment percentage on qualifying sales. Three years of payment percentages are currently set out in the Regulations:
  • 9.9% in 2019
  • 14.7% in 2020
  • 20.5% in 2021
• exemptions from payments for small companies with under £5 million in sales to the NHS each year
• arrangements for sales under framework agreements and public contracts which covers:
  • full exclusions for sales of products which are sold under such agreements which were extant at the date of coming into force of the Regulations (ie entered into on or after 1 April 2018)
  • agreements entered into on or after April 2018 but before 1 January 2019, qualify for a 7.8% payment percentage on sales
  • for agreements entered into on or after 1 January 2019, the payment percentage laid out in the Regulations will apply

In 2018, the department made forecasts of growth in branded medicines sales to set the payment percentages, which represents the amount that companies would pay back to the NHS under the statutory scheme. Those forecasts were then used to set the payment percentages as set out in the Regulations. Those payment percentages were calculated to control growth in allowed sales of branded medicines at a rate of 1.1%.

Following the consultation on the scheme in 2018, we stated that we would review the scheme annually to ensure that:

• the objectives of the scheme are still being met
• branded medicines are affordable for the NHS
• medicines are available on reasonable terms

The obligation to conduct an annual review was then included in section 29 of the Regulations.

The overarching objectives of the statutory scheme as set out in the first annual review of the Regulations are to:

• limit the growth in costs of branded health services medicines to safeguard the financial position of the NHS
• ensure medicines are available on reasonable terms, accounting for the costs of research and development
• deliver the above objectives in a way consistent with supporting both the life sciences sector and broader economy

We also stated publicly in the first annual review of the Regulations in 2019 our intention to continue to take into account broad commercial equivalence between both schemes when considering amendments to the Regulations.

Broad commercial equivalence does not mean that both schemes need to be identical, as we are keen to ensure companies have an effective choice of schemes. Our aim is to make both schemes work cohesively and in a complementary fashion to achieve the broader objectives of the schemes.

This consultation sets out the changes we are proposing for amending statutory scheme payment percentages for 2020 and 2021 to control growth at a rate of 1.1% and to help ensure broad commercial equivalence with the 2019VS.

2. Reasons for proposed changes

This consultation sets out proposals to change the payment percentages for the statutory scheme for 2020 and 2021, to come into force from 1 April 2020.

One of the overarching aims of both the statutory and voluntary schemes is to ensure the branded medicines bill to the NHS remain within allowable limits, ensuring payments made are reasonable and do not overly impact supply or research and development.

The terms of the current statutory scheme provide for the application of a 9.9% payment percentage on qualifying sales in 2019 and payment percentages of 14.7% and 20.5% in 2020 and 2021 respectively. These figures were set in 2018 and are based on forecast NHS sales of branded health service medicines.

However, based on the three-quarters of available data for 2019, growth in those sales between 2018 and 2019 was lower than forecast. This means that the current statutory scheme payment percentages for 2020 and 2021 have been set higher than required to control growth at 1.1% per year.

Therefore, given the lower than forecast growth in NHS sales of branded health services medicines, we are proposing to make changes to the payment percentages for 2020 and 2021. This is to ensure that companies are not making a higher payment than required and that payments made are reasonable and would not have potential, negative knock-on effects on supply and innovation in research and development (R&D).

Similarly, we have stated our intention of ensuring broad commercial equivalence between the statutory and voluntary schemes. Lowering the payment percentages for the statutory scheme in 2020 and 2021 would enable us to achieve this objective. This is because the current 2019VS payment percentage for 2020 is set at 5.9% to account for the lower than forecast growth.

Unless the department makes the proposed changes to the statutory scheme payment percentage, this would create a large disparity between the payment percentages of the 2 schemes as the Regulations currently set a payment percentage for the statutory scheme of 14.7% in 2020. To ensure broad commercial equivalence, we propose to lower the payment percentages as set out in Tables 1, 2 and 3 in chapter 3.

We propose that any changes to the payment percentages of the statutory scheme come into force on 1 April 2020. As the government requires time to consider the responses to this consultation as well as to reflect any changes to the Regulations that result from those responses, we will be running this consultation for 4 weeks, closing at 23:59 on 17 February 2020.

Given that the changes we are proposing are limited in scope to the payment percentages for 2020 and 2021 only, we are of the view that this gives consultees enough time to review this consultation document and to respond by the deadline set above.

Question 1: Do you agree or disagree with the proposal to change the payment percentages? Please give reasons.

3. Proposal on the level of the amended payment percentages

It is the government’s responsibility to support the NHS in providing a high-quality comprehensive health service to patients. The statutory scheme safeguards the financial position of the NHS by constraining the costs of branded health service medicines.

The scheme ensures a level of spend on branded health service medicines that delivers value to taxpayers and NHS patients while safeguarding the continuing supply of medicines to the health service on reasonable terms and taking account of research and development.

How the changes in percentages have been calculated

The proposed payment percentages for the statutory scheme are calculated using the growth of measured sales on an industry-wide level (ie including 2019VS measured sales, statutory scheme measured sales and parallel import measured sales). This is the same process that is used to calculate the payment percentages for the 2019VS and the consistency of approach means that appropriate payment percentages are set across both schemes.

The details of the methodology for the calculation are set out in the accompanying impact assessment to this consultation. The government believes that it is appropriate to continue to set payment percentages that are expected to control branded medicines growth at a rate of 1.1% each year.

In addition, the proposed payment percentages for the statutory scheme in 2020 and 2021 take account of the degree to which the 2019 payment percentage was set higher than required to control growth at 1.1% per year, considering actual (rather than forecast) growth in measured sales. Using this approach ensures compliance of broad commercial equivalence with the 2019VS where overpayments are spread out over the lifetime of the scheme and enables both schemes to be in better alignment.

An alternative ‘do nothing’ option of retaining the current payment percentages of 14.7% and 20.5% for 2020 and 2021 was also considered. However, because we will continue to control growth at 1.1% per year at this stage, ensuring companies pay the amount required to do so and ensuring broad commercial equivalence between both schemes, this option has been discounted.

Discounting this option means companies continue to have a choice between both schemes, ensures greater stability and allows the scheme to work effectively to control growth at 1.1%. It also helps facilitate the continued supply of medicines on reasonable terms, avoiding potential cost pressures on the NHS of medicines not being available on reasonable terms due to payment percentages set at a higher rate than required to control growth.

Proposed payment percentage

The tables below set out the proposed payment percentages for our preferred option. These calculations have taken into account payments that will be made by statutory scheme companies in quarter 1 2020 (January to end March 2020) at a higher payment percentage of 14.7%, a percentage which will stand until the Regulations are amended. This will ensure that the department is not receiving higher payments from statutory scheme companies than is necessary to control allowed sales growth at 1.1%.

In view of this, the payment percentage for quarter 2 to quarter 4 2020 will be 5.0% compared to 7.4% had the changes been made from 1 January 2020. However, companies that join the statutory scheme after quarter 1, and/or did not make payments at the higher payment percentage rate of 14.7% in quarter 1, will be subject to the payment percentage of 7.4% for quarter 2 to quarter 4 2020.

The proposed scenarios are illustrated below.

Table 1: By way of a comparison, the payment percentages for 2020 and 2021 in the 2019VS

Year	Percentage
2020	5.9%
2021	9% estimated

Table 2: Proposed payment percentages for 2020 in the statutory scheme

Quarter	Companies that make scheme payments in Q1 2020	Companies that make scheme payments after Q1 2020
Q1 2020	14.7%	Not applicable
Q2 to Q4 2020	5.0%	7.4%

Table 3: Proposed payment percentage for 2021 in the statutory scheme

Year	Payment percentage
2021	10.9%

The calculation takes account of where previous payment percentages have been set at a level higher or lower than needed to control growth to 1.1%. This approach is in line with the calculations in the 2019VS and supports our commitment to broad commercial equivalence between the schemes.

It ensures good functioning of the scheme, controlling allowed sales growth at 1.1% and supporting the objectives of the scheme around affordability, ensuring supply and having regard to the life sciences sector. This approach also ensures that companies have a choice between the schemes.

In contrast, a ‘do nothing’ scenario in which the payment percentage remains unchanged would not be in line with our commitment to broad commercial equivalence or our commitment to review the payment percentages when reviewing the Regulations. A higher payment percentage of 14.7% would result in higher scheme payments but it would not support the objectives of the schemes. It would also mean that government would be controlling the rate of allowed growth at a lower percentage than 1.1%, which would not support the life sciences sector. We need companies and the government to have the confidence that the scheme is working well.

We will continue to review the statutory scheme to ensure it remains fit for purpose, including the growth rate and payment percentages.

Impact of the proposed payment percentages

The impact assessment published alongside this consultation sets out that the application of a lower payment percentage in 2020 and 2021 will help to ensure confidence in the scheme and its effectiveness. The application of the lower payment percentage is expected to impact the payments received by the NHS. These will be lower than previously forecast but the proposed revised payment percentages will continue to control growth at 1.1% in line with our current public commitments.

In changing the payment percentage, the department is mindful of the need for medicinal products to be available for the health service on reasonable terms, and industry’s costs in research and development.

Question 2: Do you agree or disagree with the levels at which we propose to set the statutory scheme payment percentages? Please give reasons to explain any comments.

Question 3: Do you have any comments on the proposed methodology used in determining the payment percentages (as set out in the impact assessment)? Please give reasons and provide any evidence or analysis that would support any refinement you think the government should make.

4. Specific consultation requirements in the NHS Act

The Health Service Medical Supplies (Costs) Act 2017 amended the NHS Act 2006 to include requirements that consultation about the exercise of powers in section 263(1) (statutory schemes) must include consultation about:

• the economic consequences for the life sciences industry in the United Kingdom
• the consequences for the economy of the United Kingdom
• the consequences for patients to whom any health service medicines are to be supplied and for other health service patients

An assessment of the likely impact of the proposals, including on the above areas, is set out in the impact assessment which accompanies this consultation. However, a summary of the assessment relating to those areas outlined in the NHS Act 2006 is detailed below.

Our proposal to amend the payment percentages for the statutory scheme in line with the 2019VS will have impacts on pharmaceutical companies and their shareholders, the life sciences sector, the NHS and the wider economy.

For pharmaceutical companies and their shareholders there will be increased revenues, which is a positive for the industry.

In addition, the changes may also have a positive impact on R&D. We would expect to see a change in R&D investment of which a proportion would be felt in the UK economy. The department considers that R&D investments leads to ‘spillover’ effects – for example, through the generation of knowledge and human capital – which generate net societal benefits, compared to companies spending their capital on other things. In addition, R&D investment could lead to improved medicines in the future that would be of benefit to patients and the health service.

Please see detailed calculations on additional benefits to the UK economy in the impact assessment.

In addition to the benefits to patients through innovation, we believe that making the proposed changes to the payment percentages will also help to ensure the continued availability of medicines to patients. Changing the payment percentages supports the effective operation of the scheme, which enables companies to supply medicines to the NHS at affordable levels.

This would clearly benefit patients as they would be more likely to continue to receive the medicines they need.

Question 4: Do you agree or disagree with the analysis in this chapter, which is detailed further in the accompanying impact assessment, on: a) the impact of our proposals? b) the effect on those areas where the NHS Act 2006 requires we consider and consult?

Question 5: Do you have any evidence that would help inform, and improve the quality of, our analysis?

5. Statutory duties

There are some specific duties that must be considered when proposing changes to the statutory scheme. These include consideration of the Secretary of State’s duties under the NHS Act 2006, the Public Sector Equality Duty and the family test.

Duties under the NHS Act 2006

1. To promote a comprehensive health service (section 1 NHS Act 2006)

The Secretary of State is required to continue the promotion in England of a comprehensive health service designed to secure improvement:

• in the physical and mental health of the people of England
• the prevention, diagnosis and treatment for physical and mental illness

The proposed approach to amend the payment percentages for 2020 and 2021 to allow for broad commercial equivalence with the 2019VS will mean lower payment percentages than currently set out in the Regulations and therefore lower payments received under the statutory scheme.

While receiving lower payments might not intuitively appear to promote a comprehensive health service, we are confident that, on balance, it is the correct course of action. We therefore set out below why we think this is the case and how overall it will have a positive impact on the Secretary of State’s ability to advance this duty.

Changes to the payment percentages are required to ensure the continued functioning of the scheme. This is so it can achieve its objective of limiting the cost of branded medicines, ensuring their availability, while also taking into account the cost of R&D. Another important and relevant objective is to do the above in a way consistent with supporting both the life sciences sector and the wider economy.

Changing the payment percentages will have the effect of ensuring a suitable, commercially viable option for companies if they choose not to join the 2019VS. The effective operation of both schemes means that the department can continue to receive an appropriate amount in payments from industry. Those payments are allocated to the health service across the UK and used in the best interest of patients. This approach will help to ensure confidence in the scheme.

Under the revised payment percentages, companies will continue to make payments and growth will continue to be controlled at a rate of 1.1% per year, ultimately ensuring the affordability of medicines to the NHS and thus enhancing its sustainability. To be clear, while the department will receive less in payments by reducing the current payment percentages, the lower percentages we propose will ensure the department receives the appropriate amount in payments in line with our adjusted forecasts of growth in spend of branded medicines.

In addition, if the department was to proceed with the ‘do nothing’ option and the statutory scheme had a payment percentage of 14.7% in 2020, we consider that this may have an impact on the ability of some companies to supply branded medicines with a sustainable level of profitability.

Adapting the payment percentages will help ensure the effective running of the scheme and therefore supports the Secretary of State’s duty to promote a comprehensive health service. The department’s spend on branded medicines would continue to be controlled and payments the department receives can be used on other services for the benefit of patients.

Where companies consider that they cannot supply medicines to the NHS in way that is economic for them, they will continue to be able to request a price increase from the department. If the department was to proceed with the ‘do nothing’ option we strongly suspect that the department would receive more price increase requests. Price increase requests continue to be a way for companies to highlight where they have concerns about the provision of a particular medicine at the price agreed with the department.

If the department were to accept these potential additional price increase requests, it would clearly have an impact on the NHS’s budget for spending on branded medicines. On the other hand, if the department were to refuse them it may have a negative impact on companies’ ability to continue selling certain branded medicines to the NHS. This is why we consider that the proposed changes to the payment percentages best advance the Secretary of State’s duty to promote a comprehensive health service.

In addition, making changes will help to support the relationship between the Secretary of State and industry, ensuring that the statutory scheme has the confidence of all parties involved.

2. To act with a view to securing continuous improvement in the quality of services (section 1A of the NHS Act 2006)

The Secretary of State is required to exercise his NHS functions with a view to securing continuous improvement in the quality of services provided to individuals.

As above, following the recommended option of making changes to the payment percentages to have broad commercial equivalence with the 2019VS will ensure continued effective operation of and confidence in the statutory scheme.

This will help to ensure continuity in payments received under the statutory scheme, allowing the NHS to budget effectively and make decisions in the best interest of patients about the provision of services, including ensuring a quality service.

3. To have regard to the NHS Constitution (section 1B NHS Act 2006)

Regard must necessarily be had to the values, principles, pledges and rights in the NHS Constitution. We have considered this duty and believe that it is not negatively affected by the proposed approach.

In addition, we have considered certain elements of the NHS Constitution when considering other duties. In particular:

• principle 1: to provide a comprehensive health service available to all
• principle 4: relating to the role of patients
• principle 6: value for money in so far as this relates to the government and NHS spend on branded medicines.

We have also considered this duty in the context of the Constitution’s pledges to, and the rights of, NHS patients.

As set out above, a decision to make changes to the payment percentage helps to ensure the effective operation of the statutory scheme which is to the benefit of the NHS and industry, and means that appropriate payments are made to the health service. This supports the Secretary of State to deliver on the duty to promote a more comprehensive health service, but also ensures access to affordable medicines for patients and therefore value for money to the NHS.

4. To have regard to the need to reduce health inequalities (section 1C NHS Act 2006)

With their functions in relation to the NHS, the Secretary of State must have regard to reducing inequalities between the people of England with respect to the benefits that they can obtain from the NHS.

It is important to emphasise that this duty is separate from Public Sector Equality Duty. Socio-economic impacts need therefore to be considered in terms of other socio-economic factors such as income, social deprivation and rural isolation.

We do not envisage any negative impacts on health inequalities as a result of the proposal. We believe the proposed changes will make the statutory scheme commercially viable moving forward, and that the payments received by the department will help ensure continued access for all patients to the affordable medicines that they require.

5. To promote autonomy (section 1D NHS Act 2006)

The Secretary of State must have regard to securing, so far as is consistent with the interests of the NHS:

• that any other person exercising NHS functions or providing services for its purpose is free to exercise those functions or provide those services in the manner that it considers most appropriate
• that unnecessary burdens are not imposed on any such person

The proposed changes to the statutory scheme do not impact on the freedom of NHS bodies or providers to provide NHS services as they see fit.

6. To promote research (section 1E NHS Act 2006)

In exercising his functions in relation to the NHS, the Secretary of State must promote:

• research on matters relevant to the NHS
• the use in the NHS of evidence obtained from research

The proposed approach to ensure broad commercial equivalence with the 2019VS, including with respect to payment percentages, is expected to have a beneficial impact on the amount of R&D undertaken by industry. This is because companies will be making payments to the department in 2020 and 2021 at the level that the department thinks is appropriate to ensure affordability of medicines for the government and sufficient profitability for companies to sell to the NHS.

The department considers that R&D investments leads to ‘spillover’ effects – for example, through the generation of knowledge and human capital – which generate net societal benefits, compared to other companies spending their capital on other things. In addition, R&D investment could lead to improved medicines in the future that would be of benefit to patients and the health service.

7. To secure education and training (section 1F NHS Act 2006)

The Secretary of State must exercise his NHS (and other) functions to secure an effective system for the planning and delivery of education and training for the persons employed, or considering becoming employed, in the NHS or connected activities.

We have considered this duty in relation to the measures and do not consider it to be affected.

8. To review treatment of providers (section 1G of the NHS Act 2006)

The Secretary of State is required to keep under review any matter, which might affect the ability of healthcare providers to provide NHS services or the reward available to them for doing so.

We do not consider this duty to be affected.

Public Sector Equality Duty

This duty comprises 3 equality objectives, each of which needs to be considered separately. Ministers have regard to the need to:

• eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under the Equality Act 2010
• advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it
• foster good relations between persons who share a relevant protected characteristic and persons who do not share it

The protected characteristics covered by this duty are age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex and sexual orientation.

We do not believe there will be any disproportionate negative impact on the 3 objectives by the proposals to amend the payment percentages.

As detailed previously, by making changes to the payment percentages, we are ensuring the good operation of the statutory scheme, so the NHS continues to receive payments from companies and controls allowed sales growth. This means the NHS will continue to use those funds in the best interest of patients, including those with protected characteristics.

The family test

The Secretary of State must consider, where sensible and proportionate, apply the family test, when making policy. The family test questions are:

• a: What kind of impact might the policy have on family formation?
• b: What kind of impact will the policy have on families going through key transitions such as becoming parents, getting married, fostering or adopting, bereavement, redundancy, new caring responsibilities or the onset of a long-term health condition?
• c: What impacts will the policy have on all family members’ ability to play a full role in family life, including with respect to parenting and other caring responsibilities?
• d: How does the policy impact families before, during and after couple separation?
• e: How does the policy impact on those families most at risk of deterioration of relationship quality and breakdown?

We have considered the family test and believe the recommended changes will not have a negative impact in relation to any of the relevant questions.

Amending the payment percentages will ensure that the statutory scheme continues to function, and control allowed sales growth at 1.1%, with payments received allocated to the NHS.

If the proposed approach is taken forward with respect to question c, the scheme will continue to operate effectively, helping to support family members who require medicines and their carers to play a full role in family life through access to medicines and any services required through the NHS.

Conclusion on statutory duties

Consequently, we think that our proposal to amend the payment percentages for the statutory scheme will result in a positive impact on the Secretary of State’s ability to deliver on the relevant statutory duties.

In particular, making these amendments will help to ensure the Secretary of State continues to promote a comprehensive health service as the statutory scheme will continue to operate effectively and maintain the confidence of industry, government and the health service.

As detailed above, we believe that a number of duties are unaffected by the proposal, in particular reviewing treatment of providers, promoting autonomy and securing education and training.

Question 6: Do you agree or disagree with our initial conclusions as to the impacts that the proposed changes to the statutory payment percentages will have on the statutory duties of the Secretary of State?

Question 7: We welcome any comments, including any further evidence, that may assist us in further developing our assessment of the impact of the proposals in relation to the statutory duties of the Secretary of State.

6. How to respond

The consultation questions set out in this document are summarised in chapter 7.

The consultation will run from 21 January 2020 to 17 February 2020. We welcome responses from any interested person, business or organisation.

You can respond to this consultation by 17 February 2020 using the online form.

If you have additional evidence you wish to submit, email Statutory_scheme_consultation@dhsc.gov.uk

Or you can send your response to:

Statutory scheme consultation
Medicine and Pharmacy Directorate
3rd floor
39 Victoria Street
London SW1H 0EU

Please note that although hard copy responses will be accepted, electronic responses via online form are preferred. We ask that hard copies are only submitted by those unable to use the online form.

Comments on the consultation process

If you have concerns or comments which you would like to make relating specifically to the consultation process itself, please contact the Consultation Co-ordinator:

Department of Health and Social Care
2e26 Quarry House
Leeds LS2 7UE

Email: Consultation.Co-ordinator@dhsc.gov.uk

Please do not send consultation responses to this address.

Confidentiality of information

We manage the information you provide in response to this consultation in accordance with the Department of Health and Social Care’s personal information charter, which includes the department’s privacy notice .

The Information we receive, including personal information, may be published or disclosed in accordance with the access to information regimes (primarily the Freedom of Information Act 2000 (FOIA), the Data Protection Act 2018 (DPA) and the Environmental Information Regulations 2004).

If you want the information that you provide to be treated as confidential, please be aware that under the FOIA, there is a statutory code of practice with which public authorities must comply and which deals, among other things, with obligations of confidence.

In view of this, it would be helpful if you could explain to us why you regard the information you have provided as confidential. If we receive request for disclosure of the information, we will take full account of your explanation, but we cannot give an assurance that confidentiality can be maintained in all circumstances. An automatic confidentiality disclaimer generated by your IT system will not, of itself, be regarded as binding on the department.

The department will process your personal data in accordance with the DPA and in most circumstances, this will mean that your personal data will not be disclosed to third parties.

7. Summary of questions

1. Do you agree or disagree with the proposal to change the payment percentages? If not, please give reasons.
2. Do you agree or disagree with the levels at which we propose to set the statutory scheme payment percentages? Please give reasons to explain any comments.
3. Do you have any comments on the proposed methodology used in determining the payment percentages (as set out in the impact assessment)? Please give reasons and provide any evidence or analysis that would support any refinement you think government should make.
4. Do you agree or disagree with the analysis in the accompanying impact assessment on: a) The impact of our proposals? b) The effect on those areas where the NHS Act 2006 requires we consider and consult?
5. Do you have any evidence that would help inform, and improve the quality of, our analysis?
6. Do you agree or disagree with our initial conclusions as to the impacts that the proposed changes to the statutory payment percentages will have on the statutory duties of the Secretary of State?
7. We welcome any comments, including any further evidence, that may assist us in further developing our assessment of the impact of the proposals in relation to the statutory duties of the Secretary of State.