NHS England and NHS Improvement have released a joint tariff engagement publication that lists some of the proposed tariff reforms. These include:
- Setting next year’s price tariff to one year. This was done to maintain flexibility and ability to respond to changes within the NHS
- A blended payment approach for A&E, non-elective admissions and potentially ambulatory emergency care. This will involve a fixed payment linked to expected levels of activity, and a variable payment linked to actual levels of activity
- Abolishing the Marginal Rate Emergency Tariff (MRET) and the 30-day readmission rule. The MRET set a baseline monetary value on emergency admissions, which, when breached, resulted in hospitals receiving 70% of the national tariff price on those instances. The 30-day readmission rule incentivised hospitals to reduce unplanned emergency admissions within 30 days of discharge. Both rules resulted in providers receiving restricted payments
- Outpatient care: creation of non-mandatory prices for non-face-to-face follow-up appointments, and appointments that are non-consultant-led. This approach is intended to be further developed in future years and should result in more free time for consultants
- Updating the market forces factor (MFF): the current MFF is over 10 years old and is based on the old primary care trust (PCT) boundaries. The new MFF will instead use travel to work areas (TTWAs), updated data to calculate the MFF index and include business rates
The full proposal can be viewed here.