News / STF access criteria outlined

With many providers basing their financial plans on receiving STF payments, the mechanism for accessing the funds will be keenly received. Payments will be received from a provider's lead commissioner as a 'pass through', subject to a quarterly review process in arrears.

A letter to providers said to become eligible for STF payments, providers must first achieve their quarterly year-to-date control total. NHS Improvement said this was a ‘binary on/off switch’ – once deemed eligible, the size of the funding would be determined by success in other criteria. 

Financial performance will be linked to 70% of STF payments. These will be based on the delivery of year-to-date provider plan profile of the control total and plans must include milestones for Carter implementation and agency spend reduction.

The year-to-date control total measurement will exclude STF funding – avoiding penalising a provider twice for the same issue, for example where a proportion of the funds could be withheld because of a performance failure that incurs a contract penalty and results in a provider missing its control total.

Achievement of access trajectories – referral to treatment (12.5%), A&E (12.5%), cancer 62 days (5%) – will account for the other 30%. Diagnostics will be included, but have a 0% weighting. There will be no payment linked to sustainability and transformation plan engagement – as was proposed initially.

The letter added: ‘Providers will receive the STF if they have performance that achieves the agreed trajectory or if it delivers the national standard. This is to ensure that we do not disincentivise providers from agreeing plans that go further than just the national target but without putting at risk the funding.’

In quarter one access standard allocations were based on agreeing improvement trajectories and the process for assessment. In the three months of quarter two trusts must achieve their targets for each month to receive the full amount due in the quarter – achievement in each month will earn a third of the amount due in that quarter.

While trusts will be allowed some wriggle room on access targets initially, there will be no tolerance on achievement of financial targets. However, the letter said financial performance will be assessed each quarter, though if a trust fails to achieve its control total in one quarter but achieves it in a subsequent quarter it will receive the full amount of funding due for both quarters.

Finance will be assessed each quarter based on the agreed year-to-date control total. The final two quarters will be assessed together, based on Q3 actual year-to-date figures and Q4 forecast outturn. This will also be the case for assessing access improvement trajectories, but with Q4 performance based on provider self-assessment of forecast performance.

Q4 payments will be paid on account and could be adjusted based on outturn and performance at year-end.

Delivery of STF in 2016/17 will be subject to an annual review, which will be signed off by the Department of Health.