14.09.15
NHS Providers formally oppose changes to tariff objection thresholds
NHS Providers is opposing Department of Health (DH) plans to alter the national tariff pricing objection thresholds.
Chris Hopson, chief executive of NHS Providers, which submitted its response on the consultation’s 11 September closing date, said trusts and FTs are against the revision of the objection mechanism because “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”.
He says 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.
The DH’s consultation suggested that the objection threshold based on the provider’s ‘share of supply’ be removed.
It said: “Evidence indicates that exercising the power to prescribe a threshold for providers by share of supply has resulted in giving a disproportionate weight to views of a small group of providers with a large share of supply. As set out previously, the 2015-16 process was only triggered by 134 of 361 relevant providers by ‘share of supply’. A number of the largest hospitals were included in the 134 and would have accounted for most of the share of supply.”
Additionally, the DH is ‘minded’ to increase the objection thresholds for commissioners and providers to between 66% and 75% rather than remain on the current threshold at 51%.
Hopson said that the ultimate answer lies in ensuring that providers are commissioned and paid appropriately for safe and high quality care and that the centre works with the provider sector to create a tariff that meets this requirement.
“It’s particularly important that NHS providers, who provide the vast bulk of frontline care and who are most affected by the tariff proposals, should have an appropriate voice,” he said. “Abolishing the ‘by share of supply’ trigger gives equal weight to an NHS trust providing £1bn of care and a private provider 2,000 times smaller providing £500,000 of care. That is why the original Heath and Social Care Act deliberately included a ‘by share of supply’ trigger.”
Hopson added that NHS Providers members say they are also concerned that NHS trusts or FTs only make up 62% of ‘relevant providers’ able to object. “This means that even if every single relevant NHS provider objected to the proposals, the threshold would not be met,” he said.