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Tariff submission reflects range of NHS Confederation's membership
The NHS Confederation's response to the consultation carried out by Monitor and NHS England drew together views from the NHS Partners Network as well as the Confederation as a whole.
Separate responses were also submitted by the Mental Health Network (MHN) and NHS Clinical Commissioners (NHSCC).
Whole-system response for a whole system issue
Speaking on behalf of all the Confederation's component parts, NHS Confederation chief executive Rob Webster said:
“Our response represents the views of all of our members on the future direction for the NHS payment system. The NHS wants to see payment reform delivered at more scale and pace, so it stops being a barrier to transforming care.
“We are very concerned about how tough 2015/16 might prove for NHS services and the proposal by Monitor and NHS England to cut tariff prices by up to five per cent will be a barrier to reform and add further financial pressures to NHS providers. We do not want the NHS to be set challenge it realistically cannot achieve and their own analysis suggests more than half of providers will go into deficit if savings aren’t delivered. Cuts to prices for existing services will not drive reform. A more balanced approach is needed between driving down costs in current services through pricing cuts and funding more cost-effective models of care. This should be through better commissioning and payment systems that incentivise care that meets the needs of people today.”
“The 2015 Challenge calls on politicians to recognise the challenges facing the NHS and for the NHS to be ready to meet these challenges. The reform of the NHS payment system is central to this and this is coupled with our calls for longer term funding and transitional funding to give the NHS the room to make the changes needed.”
Marginal rate
On the marginal rate for emergency admissions, Mr Webster said:
“The 30 per cent marginal rate for emergency admissions applied to acute providers will only work as a financial lever for change where the complementary 70 per cent is clearly invested to support the reduction of admissions. We remain concerned that we will end up with a marginal tariff of 30 per cent for the whole system for this cohort of patients due to financial constraints. Maintaining the marginal rate for emergency admissions is only sensible if we can deliver the investment out of hospital and if there is more being done to make it work as an interim measure before a wider reform of the urgent and emergency care system is delivered.”
Differential deflator
Referring to the differential deflator, he added:
“The lessons from the 2014/15 tariff exercise must be applied. The Mental Health Network and our Urgent & Emergency Care and Community Services forums will be happy to help test the final assumptions made around the pricing structures.”
