Making the NHS payment and pricing system work

The Foundation Trust Network has proposed changes to the NHS payments system to help NHS foundation trusts and trusts manage the financial risks expected in 2015/16. It highlights ten issues NHS England and Monitor need to take into account in setting this year's payment and pricing system and five enablers for ensuring this process works effectively.

End of life care profiles for CCGs

The NEoLCIN has published end of life care profiles for clinical commissioning groups (CCGs) for the first time. The profiles draw together a wide range of information to give an overview of variations in cause and place of death, by age and sex, for each CCG in England. 

2015/16 national tariff discussion paper

Monitor has published a discussion paper on potential changes to the tariff in 2015/16. This provides the healthcare sector with an early opportunity to influence Monitor’s thinking as it develops its methodology for setting nationally determined prices.

Flu plan: winter 2014/15

Public Health England has published the flu plan for next winter in England. The national plan is designed to help NHS and local government organisations to develop their own local operational plans. This year the flu plan also includes details of the extension of the flu vaccination programme to children.

Publication of staffing data

NHS England has written to trusts about their progress in collecting staffing data following guidance issued with the Care Quality Commission on 31 March 2014.  The guidance outlined a number of milestones for this first phase, focusing on all inpatient areas including secondary care, community, mental health, maternity and learning disability services.

A&E performance: England 2013/14

This briefing presents key statistics on A&E performance in England. It looks at the number of people who have attended A&E, the pattern of A&E attendance over the year and how different NHS trusts compare on waiting times.

How is the NHS performing? April 2014

This is the eleventh in a series of quarterly monitoring reports on how the NHS is coping as it grapples with the evolving reform agenda and the more significant challenge of making radical improvements in productivity.

Balancing quality and finance

A crucial issue facing the NHS today is how the health service can balance the imperative to provide better care with the need to reduce costs overall. This briefing brings together the views of NHS leaders and highlights the key messages arising from a roundtable held at the end of last year. 

Hospital stays improving, finds CQC

The results of the national survey of hospital patients, published by the Care Quality Commission, suggest that people are generally having a better experience in hospital compared to a year ago.  The findings also show there’s room for improvement, with some variation in the quality of people’s stay.

Ripping off the sticking plaster: Whole-system solutions for urgent and emergency care

Mounting pressures on England’s urgent and emergency care services have been well documented in local and national media over recent months. This report from the NHS Confederation acts as a roadmap to the fundamental changes required to create a sustainable and high-quality urgent and emergency care system that can meet the needs of patients now and in the future.

Health and care systems fit for an ageing population

This report published by the Kings Fund sets out a framework and tools to help local service leaders improve the care they provide for older people.

NHS standard contract supporting documents

NHS England has published documents for use with the NHS standard contract. They include agreements for collaborative commissioning, and agreements and guidance covering contract variations.

Challenges and improvements in diagnostic services across seven days

Hospitals and primary and community care organisations are working together to look at ways of delivering safe and effective care seven days a week. NHS IQ has published a report on the potential improvements in diagnostics and scientific services.

CQC new approach to hospitals inspection: initial findings from wave 1 inspections

This report contains findings from 18 pilot hospital inspections completed in 2013, the first step in a change to the CQC's approach to inspections. Inspectors found significant variations in quality between trusts and even between services within trusts, and that apart from critical care and maternity, most services cannot demonstrate whether they are delivering effective care or not.

Review of CQC approach to inspecting hospitals

The Care Quality Commission has published findings from an independent review of its new approach to inspecting hospitals.

Better reporting of medical incidents

These alerts from NHS England and the MHRA instruct providers on steps to improve data report quality and the need for national networks to share learning and develop guidance.

New Foundation Trust documents

Monitor has recently published the following documents for foundation trusts:

· NHS Foundation Trust Annual Reporting Manual 2013/14

· Your duties: a brief guide for NHS foundation trust governors

· Revised: NHS Foundation Trust Accounting Officer Memorandum

Special measures update report

Progress report on turning around trusts in special measures, published jointly by Monitor and the NHS Trust Development Authority.

Review by Monitor of the provision of walk-in centre services in England

Monitor has identified some common themes in its review the provision of walk-in centre services in England.

Approved costing guidance

Monitor has updated its guidance to costing principles, costing standards, reference costs and Patient-Level Information and Costing Systems (PLICS) collections for 2013/14. The guide also gives details of the requirements that providers of NHS-funded services will need to comply with to meet the pricing conditions of the NHS provider licence

How Monitor and NHS England are working to make the payment system do more for patients from 2015/16

Having published the national tariff for 2014/15, Monitor and NHS England have turned to potential improvements to the payment system in 2015/16 and beyond.  The main theme is the need for new and sustainable patterns of care that can do more for patients.

Reference costs collection guidance for 2013/14

Monitor has updated its guidance to costing principles, costing standards, reference costs and Patient-Level Information and Costing Systems (PLICS) collections for 2013/14. The guide also gives details of the requirements that providers of NHS-funded services will need to comply with to meet the pricing conditions of the NHS provider licence

20 NHS trusts up for inspection under new approach

The 20 NHS trusts listed by Care Quality Commission face thorough scrutiny between April and June this year as part of CQC new approach to hospital inspections.  The list includes ULHT.

How is the health and social care system performing? January 2014

While our analysis of key performance data in the latest quarterly monitoring report shows that NHS performance is holding up well, the survey findings from finance directors working in the health and social care sectors suggest that financial pressures are increasing.

Winter plan for the NHS

Information and plans for winter including announcements about A&E winter pressure, the cold weather plan and flu immunisation.

Also see Public Health England’s winter health surveillance bulletins.

NHS Standard Contract 2014/15

The NHS Standard Contract 2014/15 and the NHS Standard Contract 2014/15 draft technical guidance has been published by NHS England. The 2014/15 CQUIN guidance has also been published with supporting documentation.

Variations in health outcome and costs among NHS providers for common surgical procedures

This study finds unexplained variation among hospitals in the four procedures covered by patient-reported outcome measures (PROMs).

Final national tariff for 2014/15

NHS England and Monitor have confirmed the arrangements for the 2014/15 national tariff, following consultation with commissioners and providers in the autumn. Monitor has published the final tariff documents and supporting guidance.

The NHS England planning guidance for 2014/15 - 2018/19

The Healthcare Financial Management Association has produced a summary of the latest planning framework from NHS England, with particular reference to the financial aspects of the framework. 

NHS waiting times for elective care in England

This National Audit Office report highlights the increasing challenge to the NHS of sustaining the 18-week waiting time standard for elective care. It also highlights the importance for trusts of having reliable performance information and shared good practice.

Guidance for efficient use of off-tariff medicines

NHS England’s medicines optimisation clinical reference group has published a document setting out how NHS England can work with providers incentivise more efficient use of high cost drugs excluded from the national tariff

New Foundation Trust Documents

Monitor has published the following documents for Foundation Trusts: 

Arrangements to support NHS foundation trusts contemplating mergers

 Briefing for commissioners on the NHS provider licence and Commissioner Requested Services 

Survey on the cost structures of providing urgent and emergency care

New HSCIC performance reports

Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation, England, July 2012 - June 2013, Experimental statistics 

Use of NICE-appraised Medicines in the NHS in England - 2012, Experimental statistics

Hospital outpatient attendances up by 3.9 per cent

These outpatient attendance figures are published  in  Hospital Outpatient Activity 2012/13.  The HSCIC report also shows that the treatment specialties with the highest number of attendances included Trauma and Orthopaedics, Ophthalmology, and Physiotherapy.  ULHT figures are included.

Monitor to extend role to promote patient welfare this winter

Monitor has agreed to supplement its routine monitoring of the operational performance of foundation trust hospitals to help them tackle any seasonal pressures on emergency care. 

Monitor and NHS England publish new rules for the 2014/15 NHS payment system

New rules will come into force next year allowing local experiments in ways of paying for NHS-funded services in order to develop innovative new models of care for patients. The rules were successfully consulted on by NHS England and Monitor over the autumn.

Monitor seeks better planning by foundation trusts

NHS foundation trusts will have to work with local commissioners to transform radically how they operate over the next five years in order to provide quality care for patients on a sustainable basis, says Monitor.

Monitor to protect essential services by licensing independent providers

Monitor believes the expansion of its provider licence regime to include independent providers can be used to make sure that patients continue to receive the essential services they need and that providers are paid a fair price for those services. 

Winter plan for the NHS

Information and plans for winter including announcements about A&E winter pressure, the cold weather plan and flu immunisation.

The BMA has also published a briefing paper to help explain why there is increased pressure on the NHS in winter, the impact on NHS services and the need for a longer term solution.

Also see Public Health England’s winter health surveillance bulletins.

New report on seven-day NHS services

NHS Improving Quality has published case studies and examples of how hospitals, community health and social care services across the country are working together to deliver routine services seven days a week.

NHS England has published findings of an investigation into seven day services across the NHS.  It points to significant geographical variation in outcomes for patients admitted to hospitals at the weekend.

Dr Foster hospital guide 2013

This guide looks at the way money is spent on hospital treatments, the impact of drug and alcohol problems on patients and hospitals, quality of care at weekends and the measurement of hospital mortality. 

Data on ‘never events’ to be more specific

NHS England has published more detailed data about “never events” by hospital.

Good practice guide to major service change

NHS England has published a good practice guide for CCGs considering major service changes.

See also Everyone Counts: Planning for Patients 2014/15 to 2018/19, NHS England’s vision for service transformation in the context of significant financial challenge. The guidance comes with planning tools. The HFMA has produced a summary.