News / Maternity tariff issues raised

A number of NHS trusts have raised concerns about projected reductions in maternity income under proposed tariffs for 2010/11.

The estimates have surfaced during the tariff road test exercise and appear at odds with the requirement on trusts to invest in maternity services under the maternity matters policy.

The problems have arisen despite some significant increases to the main delivery healthcare resource groups

Healthcare Finance spoke to several trusts with concerns. In general they said the gains on delivery HRGs were being more than offset by reductions in tariffs for non-delivery contacts.

A small sample of trusts reported net reductions of between £1m and £3.5m from the changes.

The non-delivery HRGs, NZ04 to NZ09, were introduced under HRG4 to replace the single N12 non-delivery admission HRG, so enabling prices to better reflect actual clinical activity and costs.

But the Department of Health has acknowledged that ‘the new HRGs continue to be subject to what appears to be inconsistent coding and poor costing’.

The PBR draft guidance said that where antenatal tariffs were ‘clearly unreflective of actual local costs’, payment flexibilities should be considered.