What comes into force in April 2018?


29 / 03 / 2018

From integrated care systems to the sugar tax, our summary details the key changes taking effect this month and where you can find further information and guidance.

You can also access a comprehensive list of measures which came into effect in October 2017.


Data collection
Innovation Transformation
Data security
Public health


Prescription charge rise

Charges for prescriptions in England will increase by 20 pence from £8.60 to £8.80 for each medicine or appliance dispensed. Charges for wigs and fabric supports will also be increased in line with inflation. The cost of the prescription prepayment certificates (PPC) has been frozen, with the 3-month PPC remaining at £29.10 and the cost of the annual PPC at £104.

Find out more
Revised charges for 2018 to 2019 can be found on the Gov.UK website.

Increase to NHS-funded nursing care rate

The NHS-funded nursing care standard weekly rate per patient will increase by 2 per cent to £158.16 on 1 April. This is to reflect overall nursing wage pressures.

The higher rate of NHS-funded nursing care will also increase by 2 per cent to £217.59 per week. This is only relevant for people who were already on the higher rate in 2007 when the single band was introduced.

As stated on NHS Choices, “NHS-funded nursing care is care provided by a registered nurse for people who live in a care home. The NHS will pay a flat rate contribution directly to the care home towards the cost of this registered nursing care.”

Find out more
Full details can be found on the Department of Health and Social Care website.

Data collection and reporting

Mandation of acute activity at patient level

It will be mandatory for designated acute NHS foundation trusts and NHS trusts to record and report the costs of acute activity at a patient level, in line with the healthcare costing standards for England.

The move was ratified at NHS Improvement board in January 2018, following a consultation in 2017.

Find out more
Access key information and the approved costing guidance from the NHS Improvement website.

New cancer waiting times data collection

A new cancer waiting times data collection system, which makes it possible for us to measure the new 28-day faster diagnosis standard, will go live from in April.

It forms part of a programme intended to revolutionise cancer care through delivering the recommendations of the Independent Cancer Taskforce report.

Find out more

Head to NHS Digital’s website for further information on the data set.

Post-infection review process for MRSA bloodstream infections (BSI)

The post-infection review process is changing as of this month, becoming a local process and will only be required for organisations above a certain MRSA BSI rate threshold – approximately 15 per cent of clinical commissioning groups (CCGs) and non-specialist NHS trusts.

The mandatory reporting of MRSA BSI will continue as before.

Find out more
NHS Improvement’s website describes the requirements for the reporting and reviewing of BSI caused by MRSA and includes the trusts and CCGs that will need to carry out post-infection reviews locally.

Data security

New data security toolkit

The new Data Security and Protection Toolkit will replace the Information Governance Toolkit, forming part of a new framework for assuring that organisations are implementing the ten data security standards and meeting their statutory obligations on data protection and data security.

Social care providers that provide care through the NHS Standard contract also need to comply with the new toolkit. And local authorities have been advised to complete the toolkit for adult social care, public health and other services that are:

  • receiving services and data from NHS Digital
  • and / or are involved in data sharing across health and care where they process the personal confidential data of citizens who access health and adult social care services.

Find out more
Access further information and guidance from the 2017/18 data security and protection requirements document published by the Department of Health and Social Care and NHS England in January 2018.


Business rates retention

Ten areas and London will begin to pilot 100 per cent business rates retention, “to help meet the commitment to give local authorities more control over the money they raise locally”, the Ministry of Housing, Communities & Local Government announced in December 2017.

Find out more
View the Ministry of Housing, Communities & Local Government’s statement for further details.


Introduction of the Accelerated Access Pathway

The Accelerated Access Pathway comes into force, providing a new route to market that will ‘streamline regulatory and market access decisions’. Detailed in its response to the Accelerated Access Review (AAR), the government said:

“We will make the process from bench to bedside quicker, cheaper, and easier for innovators and the NHS. The Government’s ambition is to bring forward by up to four years patient access to these selected, highly beneficial and affordable, innovations.”government’s response to the AAR.

Find out more
Download the government's response to the AAR.

Public health

Soft drinks industry levy

The new levy, known as the sugar tax, will take effect from 6 April. As detailed on the Gov.UK website, the levy encourages producers of added sugar soft drinks to:

  • reformulate their products to reduce the sugar content
  • reduce portion sizes for added sugar drinks and importers to import reformulated drinks with low added sugar to encourage consumers of soft drinks to move to healthier choices.

“If they do this, producers and importers of added sugar soft drinks can pay less or even escape the charge altogether.”

Find out more

Full details on who the levy, including who applies to, can be found on the Gov.UK website.


CQC fees

The Care Quality Commission’s latest regulatory fees scheme comes into effect on 1 April, with the community social care sector the only sector that will see an overall increase in fees.

Find out more
Access information and guidance on the regulatory fees for 2018/19 from the CQC website, where you can also access the fees calculator.

New licence condition for NHS-controlled providers

NHS Improvement is introducing a new provider licence condition for NHS-controlled providers.

An NHS-controlled provider is neither and NHS trust or NHS foundation trust. It is required to hold a provider licence, and ultimately controlled by one or more NHS trusts and/or foundation trusts,  where ‘control’ is defined on the basis of IFRS 10.

Such providers must ensure that from 1 April they are appropriately licensed.

Find out more
NHS Improvement’s licencing application guidance has everything you need to know.

Revalidation for pharmacists and pharmacy technicians

Pharmacists and pharmacy technicians will be required to go through revalidation to renew their professional registration.

The change has been made by the General Pharmaceutical Council (GPhC) and will replace the continuing professional development (CPD) only system.

Find out more
Head to NHS Employers’ website.


Integrated care systems launched

Although the first wave of integrated care systems already have accountability for local operational and financial performance, from April the ten areas will begin to gain new financial flexibilities.

The systems – collaborations between NHS bodies and their local authorities to take collective responsibility for the health of their populations – will also use new tools for better understanding local health data.

The ten areas are:

  1. South Yorkshire and Bassetlaw
  2. Frimley Health and Care
  3. Dorset
  4. Bedfordshire, Luton and Milton Keynes
  5. Nottinghamshire
  6. Blackpool and Fylde Coast
  7. West Berkshire
  8. Buckinghamshire
  9. Greater Manchester (devolution deal)
  10. Surrey Heartlands (devolution deal)

Find out more
Visit" NHS England’s web page on integrated care systems.

Discover more in this NHS Voices post from NHS England’s national director of health system transformation.

Expansion of HCV treatment

The Hepatitis C (HCV) programme will move to the next level in its expansion from April, with a further rise in annual planned treatment rates to 13,000.

Find out more
Get the latest update in this blog post on NHS England's website.


GP contract changes

Changes to the General Medical Services (GMS) contract in England for 2018/19, in effect from 1 April, will see an investment of £256 million, an overall contract uplift of 3.4 per cent.

The changes include:

  • an investment of £60 million to cover GP indemnity costs for 2017/18
  • an uplift to allow an increase to the Item of Service (IoS) fee for certain vaccination and immunisations (V&I) from £9.80 to £10.06, in line with consumer price index inflation
  • an uplift of £22 million to allow a change in the value of  a Quality and Outcomes Framework (QOF) point as a result of a Contractor Population Index (CPI) adjustment
  • a non-recurrent investment of £10 million to recognise additional workload associated with the implementation of e-Referral contractual requirements.

Find out more
Head to NHS Employers’ website for full details and a summary of the agreement.

Advanced paramedics to prescribe drugs

New laws, which come into force on 1 April, will allow the most qualified and experienced paramedics to prescribe medication for patients who do not need hospital treatment.

Find out more
NHS England’s web page on paramedic prescribing has full details. You can also view the press release announcing the move.

Clinical excellence awards scheme

NHS Employers and the BMA have agreed that from 1 April 2018, trusts must run annual local clinical excellence award rounds.

The changes, which are endorsed by the Department of Health and Social Care, state that:

  • trusts must run local clinical excellence awards (LCEA) rounds from 1 April 2018
  • from 1 April 2018 to 31 March 2021, the minimum investment ratio for new LCEA will be set at 0.3 points per eligible consultant.

Find out more
NHS Employers’ website has full details.

Changes to study budgets for junior doctors

As noted on the British Medical Association website, April 2018 ushers in new study budget arrangements “designed to improve transparency and equity for junior doctors across England.”

Health Education England will now oversee the administration of study budgets from a local office, with funds pooled, allowing greater flexibility to distributing the money.

"The intention is that this will result in a more transparent system, with all funds guaranteed to be used for the education and training of junior doctors."

Find out more
The BMA’s education and training tariff web page has further details.

Visa and immigration applications

Fee increases for visas and immigration applications will be effective from 6 April.

Find out more
Head to the Home Office's immigration nationality fees table.

Income thresholds for indefinite leave to remain

Migrants applying for indefinite leave to remain must meet the minimum annual salary threshold as part of the eligibility criteria, which will increase to £35,500 on 6 April.

The salary thresholds are based on guaranteed pay. Employers should factor this in when considering workforce planning after 6 April 2018.

Find out more
NHS Employers' round-up of recent announcements relating to international recruitment has everything you need to know.

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