Mental health network

National tariff proposals for 2017/18 and 2018/19

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Published by NHS Improvement and NHS England August 2016

Deadline for submissions 26th August

MHN is seeking member views on the tariff engagement document published last week by NHS England and NHS Improvement.

The engagement document seeks views on certain proposals by the national bodies for changes to the national tariff, along with other proposals relating to the pricing system.

The proposals – include four new best practice tariffs, the introduction of new innovation and technology tariff, and changes to local payment rules for mental health.

In particular the policy proposals for the next national tariff are set for two financial years (2017/18 and 2018/19).

The feedback received will be used to develop the proposals that they will include in the statutory consultation on the next national tariff. The statutory consultation will take place later this year.

Mental health proposals

In summary the proposals in the tariff document on mental health are to link prices to locally agreed quality and outcome measures and the delivery of access and waits standards. The way they intend to do this is to require the use of one of three options in locally determined prices:

  1. Episode of treatment or year of care, as appropriate to each mental healthcare cluster;
  2. Capitalisation, informed by care cluster data and other evidence, or
  3. An alternative payment approach consistent with the rules for local pricing and existing policy to move away from poorly specified and evidenced contracts

    Furthermore, the proposals mandate the use of the IAPT payment model from April 2018.

    Emergency care, system wide outcome metrics and STPS

    Emergency care, system wide outcome metrics and STPS

    As part of the development of new models of care NHS I looking to develop local variation templates to support changes to the way emergency care is provided locally. The local variation would support moving towards a payment approach where providers and commissioners would agree an overall level of activity and spend on emergency activity that could be overlaid with a gain and loss share. Payment would also be linked to achieving system wide quality and outcomes metrics decided locally and aligned with Sustainability and Transformation Plan (STP) objectives.

    1. To support CCGs in commissioning evidence-based services from care homes that help to reduce admissions to hospital.
    2. For mental health services to align incentives between secondary and tertiary services.
    3. For advice and guidance from a consultant to a GP.

      Any local variation would need to be agreed by providers and commissioners. To assist these local agreements, we will look to develop a template that local organisations could use or adapt based on individual circumstances. More detail of this local variation would be published alongside the statutory consultation.

      Key questions

      MHN is interested to hear your views on the tariff engagement document. Please share your views on:

      1. What general views do you have on the proposals in the document?
      2. Do you welcome the multi-year tariff? What difference does this make to the baseline?
      3. Is mandating the IAPT payment model from 2018 realistic?
      4. Does your local system (provider and commissioner) feel ready for this level of change|?
      5. Is their capacity within your provider system to manage this change including information and technology?
      6. Do you have clinical buy in and leadership with the new payment models?
      7. What are your views/concerns on the system wide metrics for emergency care?

      Please send your comments to by 19th August

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