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The National Tariff

The National Tariff . Ric Marshall Director of Pricing . www.monitor.gov.uk. 2012 Act splits price setting role between NHS England and Monitor. NHSE leads on:. Monitor leads on:. Scope and design of currencies Variation rules to National Tariff currencies . Pricing methodology

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The National Tariff

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  1. The National Tariff Ric Marshall Director of Pricing www.monitor.gov.uk

  2. 2012 Act splits price setting role between NHS England and Monitor NHSE leads on: Monitor leads on: • Scope and design of currencies • Variation rules to National Tariff currencies • Pricing methodology • Regulated prices • Local modifications • Rules for local pricing and non-tariff pricing Close working and agreement

  3. Monitor’s Price Setting Role Our price setting role has potential to bring significant benefits to patients • Tariff setting not just a method for allocating funds: • Signalling financial implications of decisions can influence behaviours of commissioners and providers… • …and, in turn, improve quality of outcomes for patients at the same or lower cost

  4. 2014/15 National Tariff

  5. Not all prices use a National set price…. • Local determined prices are: • Local modifications – increases in national prices for services that are uneconomic for structural reasons, which must be approved by Monitor • Local variations – adjustments to national prices or currencies that are agreed by providers and commissioners, and must be published • Local prices – locally negotiated prices for services that do not have national prices, including some services with national currencies • Must adhere to the rules set out in the 2014/15 National Tariff • Prices for ambulance services contracted by commissioning organisations will follow these rules

  6. Patient Level Costing

  7. Reviewing Urgent and Emergency Care • Monitor is currently reviewing models of payment for urgent and emergency care • Early Findings: • High levels of fixed and semi-fixed costs regardless of demand because of required capacity – reducing demand doesn’t reduce costs • Variety of cost structures across the components of urgent and emergency care • Emerging Themes for Reform • Better coordination across providers to improve outcomes • Earlier intervention to reduce demand for emergency care • Recognition of the need to maintain a level of coverage and the fixed costs associated • Local discretion to design models that are responsive to the needs of local populations • Improving quality of data

  8. The Pricing Timeline Early 2014 Spring 2014 Summer 2014 Autumn 2014 Draft long-term strategy for payment design Policy Forward Look Final long-term strategy Payment system • National Tariff Document for 2015/16 • 2015/16 National Tariff Methodology Discussion paper • Tariff Engagement Documents • National Tariff Document Statutory Consultation Tariff development Publication of 2012/13 PLICS pilot Costing Direction of Travel Costing Guidance for 2014 Costing Start ofpricing case management and local determined prices Casemanagement

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