Acute providers will be paid at a bonus rate for carrying out additional operations as part of national officials’ ongoing attempts to cut waiting lists, HSJ has learned.
NHS England, Monitor and the NHS Trust Development Authority have written to providers revealing the plan, amid growing concern about failure to meet flagship referral to treatment targets, and a failure to cut waiting lists during the summer.
Their letter, sent in recent days, said they would pay providers 115 per cent of the normal tariff rate for procedures carried out, on top of those which they agreed with commissioners in annual contracts in the spring.
It said: “The additional activity undertaken between 1 October and 30 November will be paid at 115 per cent tariff rate, with the appropriate market forces factor applied.”
The government announced an additional £250m funding for the NHS in June to pay for additional elective work. There has been speculation among senior NHS leaders recently about the possibility of further extra allocations.
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However, the letter said officials “expect that all this activity will be funded from the £250m allocated… in June this year”.
The letter said commissioners and trusts should now agree detailed plans and “formal contract variations… with activity levels agreed between providers and commissioners” by 3 October.
It is thought the additional rate will help trusts meet extra costs to ensure they can carry out additional activity, and incentivise them to do so.
National officials had hoped substantial additional activity would be carried out between June and August. However, a separate email sent to foundation trusts earlier this month by Monitor managing director for provider regulation Stephen Hay confirmed this had not happened as planned.
He said: “As you know, extra funds were made available to support additional elective activity over the period from July through to the end of October.
“Commissioners were asked to confirm the levels of activity expected from each provider over this period.
“Unfortunately, current indications are that providers’ overall performance for the first two months is well below that expected detailed in those plans, and we are concerned that this may reflect differences in understanding between providers and commissioners as to how firm the commitments to undertake extra activity were.”
Health secretary Jeremy Hunt announced in August that there would be a “managed breach” of the flagship elective referral to treatment waiting time targets while the service carried out additional activity, including focusing on treating many patients who have been on waiting lists for more than 18 weeks. He said “by the end of the year the NHS will start meeting the target again”.