News / Standard contract ‘a mixed bag’ for providers

As NHS England confirmed the final version of the contract for the new financial year, Mr Hopson said: ‘The final 2015/16 contract offers a mixed bag for providers. We strongly welcome the fact that NHS England has listened to providers and our representations
on the proposed fine levels for breaches of targets on four-hour A&E waits and two of the 18-week referral to
treatment targets.’

However, he was concerned about changes to the point at which A&E breach penalties would now kick in. This would put more pressure on A&E departments, he said.

The performance floor for A&E in any given month – the threshold beyond which the value of the sanction will not be increased – has been reduced from 92% to 85%, although the sanction per excess breach has been reduced from £200 to £120.

On 18-weeks performance the sanction remains the same, at £400 for admitted pathway breaches and £100 for non-admitted, while the penalty for incomplete pathways will increase from £100 to £150.

According to technical guidance on the contract, there were more incomplete pathways than admitted or non-admitted completed pathways.

‘Therefore,’ it continued, ‘although the sanction per breach for individual incomplete pathways is relatively low at £150, the overall financial impact on providers of failing to achieve the 92% incomplete standard is likely to be high.’

Broadly speaking, the guidance estimated that more than 50% of 18-weeks sanctions nationally will now be the result of performance on incomplete pathways.

This reflected the critical importance of ensuring that backlogs of long-wait patients do not build up.