News / Planning concerns over tariff delay

NHS finance managers have warned that the delays in publishing next year’s contracting rules, tariff and primary care trust allocations are undermining their ability to plan for 2009/10 and beyond, writes Steve Brown.

The publication of PCT allocations, originally due at the beginning of the summer, had already been delayed until after the parliamentary recess. But last month the Department announced a further delay, including delays to the operating framework for 2009/10 and the payment by results tariff.

The Department said the delay was a result of needing to ‘look to a five year time frame, rather than just the next two years’. It added that the new funding formula and tariff calculations were ‘complex changes’ that needed to be ‘refined further’ to enable robust financial planning in the NHS. The operating framework is now expected to be published in December.

Although finance directors said the delay was unhelpful in planning for next year, they acknowledged the need to ensure the tariff was as accurate as possible given potential destabilisation.

There was still uncertainty about whether next year’s tariff will be based on the new version of healthcare resources groups (HRG4) as planned. However a majority of finance managers spoken to by Healthcare Finance expected the HRG4 tariff to go ahead, albeit informed by the more recent 2007/08 reference costs and cushioned by some form of transitional arrangements.

Finance managers have also been looking for other clues on next year’s tariff. Minutes from a summer meeting of the payment by results technical working group suggest that the market forces factor (MFF) is likely to become a local payment. There are concerns that this could be seen as introducing local price differences between trusts. The extent of these differences will depend on possible changes in cliff edges between neighbouring trusts in the review of the MFF, due to be unveiled alongside the allocations.

It is understood that the costs of patient transport services have been stripped out of the acute tariff, enabling PCTs to take responsibility for commissioning these services. And the working group has also discussed the possible introduction of a planned same day tariff, providing different tariff prices for day case and overnight elective activity.