Detail of outcome
Monitor’s analysis shows that around 13% of clinical commissioning groups, 37% of relevant providers by number, and 75% of relevant providers by share of supply, objected to the proposed method for determining national prices for NHS services.
As the share of total tariff income received by the objecting providers exceeds 51%, the National Tariff cannot be introduced in its current form at this stage and its implementation will be delayed.
Monitor and NHS England are now considering the feedback received from the consultation and possible next steps, in the context of what the legislation permits in the event that an objection threshold is breached.
Read Monitor’s full statement on the national tariff payment system 2015/16 consultation.
This consultation notice sets out the proposed price lists and payment rules for NHS services for 2015/16 and will support NHS healthcare commissioners and providers to improve the quality and efficiency of care for patients.
Monitor and NHS England previously consulted NHS organisations about how the payment system works and listened to their feedback.
To coincide with the launch of the consultation Monitor and NHS have updated their leaflet, which explains how the NHS payment system helps to improve care for patients.
What’s being proposed
The National Tariff is a practical package of measures that offers a realistic balance between the need for NHS providers to maintain quality services and the ability of commissioners to pay for them.
Among the range incentives and signals for NHS providers and commissioners to manage demand and deliver against national standards are 3 specific changes for 2015/16:
- expecting acute providers to achieve efficiency improvements of 3.8%
- introducing a new price-setting rule for specialised services
- revising the marginal rate rule for emergency admissions
Who can take part
Monitor welcomes responses from anyone interested in the NHS payment system and encourages comment on any of the proposals in the consultation notice.
However, the Health and Social Care Act 2012 provides for a specific process under which clinical commissioning groups and ‘relevant providers’ (NHS foundation trusts; licensed independent providers; NHS trusts and unlicensed independent providers who provide NHS services where there is a proposed national price) may object to the method for determining national prices.
You can find out more in Annex B of the consultation document about the objection process and how Monitor will calculate any objection percentages.
The consultation period ends immediately before midnight at the end of Wednesday 24 December 2014.
A number of supporting documents will help your reading of the ‘2015/16 National Tariff Payment System’:
This handy guide explains all of the different elements of the proposed 2015/16 National Tariff and its supporting documents
Impact assessment for the proposals set out in the ‘2015/16 National Tariff Payment System: A consultation notice’
This compares the proposals for the ‘2015/16 National Tariff Payment System’ to the ‘2014/15 National Tariff Payment System’.
Explains how Monitor and its regulatory partners will enforce the national tariff on commissioners and providers.
How to submit local variations and local prices to Monitor, and how to agree to or apply for a local modification to a national price.
In addition to the guidance, there are also a set of associated templates:
- local variations template (Excel)
- local variations worked example (Excel)
- local modifications template (Word)
- local prices template (Excel)
Guidance on mental health currencies and payment (plus Excel annexes)
Describes how providers can use the adult mental health currencies, and how they can be used by commissioners and providers as the basis for setting local prices. The guidance contains the following annexes:
- Annex E: Coefficient reference table algorithm
- Annex F: Discriminant Fischer scores algorithm
- Annex G: Algorithm spreadsheet (Excel 2004 version)
- Annex H: Algorithm spreadsheet (Excel 2007 version)
Outlines which services are included in the maternity pathway payment and explains how to implement the payment system.
Provides information on the calculation and application of the Market Forces Factor, a nationally determined variation to the national price, in 2015/16.
Provides operational information for implementing the 2015/16 national tariff.
How NHS providers and commissioners can use local payment arrangements to support service improvement and reconfiguration.
Provides a worked example to applying the Default 50:50 default gain and loss sharing rule calculation outlined in Section 8 of the ‘2015/16 National Tariff Payment System: A consultation notice’.
Contains the non-mandatory prices model and price list for the ‘2015/16 National Tariff Payment System: A consultation notice’
The HRG4 2015/16 Consultation Grouper from he Health and Social Care Information Centre should be used to group data and derive HRGs, support data quality, conduct what-if-modelling, and assess local reimbursement that will be received under the national tariff for the 2015/16 financial year.