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pound-coinsDecember 1 2014

A consultation on how NHS payments are to be made could change the way some primary care service payments are made in 2015-16.

NHS England and Monitor are proposing the changes which “aim to incentivise the efficient provision of high quality care, while encouraging the better management of an increasing demand for services.”

The proposals tie in with the Five Year Forward Views to encourage the NHS to innovate and change local patterns of care in response to patients’ needs.

The consultation points out that NHS services are becoming more integrated, with some NHS services provided across multiple settings, including primary care. Many of these services are governed by the NHS Act 2006 and this consultation will not apply to them.

However, “in other cases, the payment for NHS services provided in a primary care setting is not determined by or in accordance with regulations or directions, or related instruments, made under the 2006 Act: the payment is agreed between the commissioner and provider. In such circumstances, the ‘2015/16 National Tariff Payment System’ rules on local price setting apply.”

The policies in the ‘2015/16 National Tariff Payment System’ have been designed to work alongside other legal provisions for the payment of NHS services to support better alignment of disparate payment approaches and foster integration. Clinical commissioning groups have expressed an interest in co-commissioning primary care with NHS England area teams.

“As a result, we envisage that many local areas will seek to align their payment arrangements for core and enhanced primary care services with payment arrangements for other NHS services covered by the national tariff.

“NHS England is considering a range of contractual options for commissioners and will be sharing progress in the coming months.”

It continues: “Some GPs conduct simple procedures, which they have been commissioned to perform by CCGs to bring care closer to patients’ homes. For the avoidance of doubt, such procedures are not covered by the nationally specified currencies and prices. Instead, and in relation to the ‘2015/16 National Tariff Payment System’, the commissioning of these procedures is covered by the rules for local price-setting.”

For outpatient care, consultant-led outreach clinics held in a GP practice should be eligible for the national price.

"Services previously known as ‘locally enhanced services’ and now commissioned by CCGs through the NHS Standard Contract (eg where a GP practice is commissioned to look after patients living in a nursing or residential care home)” must have the rules for local payment applied.

The consultation is open until December 25.

Links:

NHS England announcement

National tariff payment sustem 2015-16 consultation notice

Consultation document

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