• All PACs told their growth rate in emergency admissions per 1,000 population must be 3 per cent less than the rest of England
  • MCPs told growth must be 1 per cent lower
  • If vanguards do not meet conditions, NHS England will discuss the funding with STPs

NHS England has told national vanguard sites that their emergency admissions growth will need to be significantly lower than elsewhere to secure access to their national transformation funding in the second half of 2017-18.

In a letter, sent on Wednesday to primary and acute care system and multispecialty community provider vanguards, NHS England said it expects the growth in emergency admissions per 1,000 population for each PACS to be 3 per cent lower than the rest of the country and 1 per cent lower in every MCP.

The national commissioner said it will be analysing PACS and MCP performance on emergency admissions over the first two quarters of 2017-18. It will use this to determine how it releases funds in quarters three and four. Funding for quarters one and two will be “unaffected”.

The sites were told thaht if they do not hit the required rates, NHS England “will trigger a conversation with [their] local STP to determine how funds will be spent”.

The letter, seen by HSJ, said over 2016-17 “MCP vanguards had a growth rate [per] 1,000 population of 2.5 per cent, compared to the base year [2015], and PACS vanguards 0.8 per cent. Both continue to compare favourably to the non-vanguard growth of 3 per cent.”

It continued: “To show that vanguards are continuing to lead the way in this key area of focus, we are expecting each vanguard to continue to have lower growth in emergency admission per 1,000 population than the rest of the country in 2017-18.

“In line with last year’s performance for PACS and MCPs, we expect the growth rate for each individual PACS vanguard to be 3 per cent lower than the rest of England, and for each individual MCP vanguard, 1 per cent lower, compared to the base year ending September 2015.”

The letter said: ”The Next Steps [on the Forward View] document made clear that we need to continue to focus on the level of emergency admissions to hospital in 2017-18, and this is being seen more widely as a benchmark of success for both the NHS in aggregate, and vanguards specifically.”

NHS England will monitor the year on year performance in each site at 30 June 2017 and 30 September 2017.

“We have analysed likely future performance against this metric, based on results to date, and will be in touch individually with vanguards who are at risk of not meeting this condition,” the letter said.

Earlier this year vanguards were told the conditions on their 2017-18 funding. NHS England has now told the sites funding will not be conditional on meeting the specific conditions set out in these original letters.

As with 2016-17, access to transformation funding is conditional on whether all “significant vanguard partners” have accepted their control totals for 2017-18.