National tariff payment system 2015/16: a consultation notice

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. Supporting documents

A number of supporting documents will help your reading of the ‘2015/16 National Tariff Payment System’:

A user guide to ‘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’.

Enforcement of the national tariff for 2015/16

Explains how Monitor and its regulatory partners will enforce the national tariff on commissioners and providers.

Guidance on locally determined prices for 2015/16

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)

Maternity pathway payment system: guidance for NHS providers and commissioners

Outlines which services are included in the maternity pathway payment and explains how to implement the payment system.

A guide to the Market Forces Factor

Provides information on the calculation and application of the Market Forces Factor, a nationally determined variation to the national price, in 2015/16.

The national tariff information workbook

Provides operational information for implementing the 2015/16 national tariff.

Supporting innovation in the NHS with local payment arrangements

How NHS providers and commissioners can use local payment arrangements to support service improvement and reconfiguration.

Worked example to Default 50:50 gain and loss sharing rule

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’.

A model for non-mandatory prices

Contains the non-mandatory prices model and price list for the ‘2015/16 National Tariff Payment System: A consultation notice’

Draft local payment grouper 2015/16

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.