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28.09.15

Exclusive: National Tariff timeline still challenging and delays 2017-18 work

Publishing the statutory consultation on the 2016-17 National Tariff in the proposed timeline “remains challenging”, causing work on the 2017-18 tariff to be delayed against plan.

Board papers for Monitor’s meeting on 30 September reveal "ongoing challenges" in sorting out the next financial year’s National Tariff and the government’s upcoming Spending Review. Because of the challenging timeline and a “number of key external interdependencies”, Monitor must now decide on several contentious topics “very rapidly” after the current Spending Review round finishes and NHS England’s mandate is finalised.

The regulator’s pricing team is therefore exploring options, including arbitration “if necessary”, to agree on major components that form part of the tariff.

They are also working to replan the current 2017-18 work packages.

In April, Monitor warned that plans to publish an agreed draft version of the 2016-17 tariff by mid-May would be “challenging”, with Tony Lambert, director of pricing, saying “prompt agreement” on the scope and content was required to publish the Tariff Engagement Document (TED) in June.

In August, NHS England and Monitor decided that, instead of a TED, they would publish a series of consultation documents on proposals for the tariff instead.

The controversial document has faced a backlash, with NHS Providers opposing plans to alter the National Tariff pricing objection thresholds based on providers’ ‘share of supply’ – which the Department of Health suggested should be removed.

Its chief executive, Chris Hopson, submitted a response ahead of the consultation’s 11 September deadline saying that trusts and FTs are against the revision of objection mechanism.

He said: “The setting of national tariff prices for treatments is crucial to providing high quality care for all patients and service users and providers must have a clear voice in a collaborative tariff setting process.”

Hopson added that the fact the mechanism was triggered last year ahead of the 2015-16 tariff was not a symptom of the mechanism being wrong, but a reflection that the initial proposals were undeliverable and an unacceptable risk to the quality of patient care.

In August, it was revealed that proposed NHS price changes outlined in Monitor’s impact assessment for 2016-17 will cut nationally priced income of private providers by 7%, making them amongst the hardest hit by the new tariff.

The revenue reduction is largely caused by the cuts in orthopaedics prices, which have mostly fallen by more than 10%.

In Monitor’s board papers ahead of this week’s meeting, it said, despite the pricing team holding “summer engagement events” to inform and receive feedback from the sector about proposals for 2016-17, work is still ongoing in some specialities – including orthopaedics.

Further work is also ongoing in nephrology/dialysis, paediatrics and cardiology.

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