Hospitals are planning to lobby the government over the steep cuts to maternity income expected in 2011-12.
England’s two specialist women’s hospitals, Birmingham Women’s NHS Foundation Trust and Liverpool Women’s NHS Foundation Trust told HSJ they will meet to discuss how to lobby against losses of around 4 per cent to their maternity income next year due to tariff changes.
For both, the bulk of the loss will be felt in outpatient payments.
The 2011-12 tariff is intended to reduce hospital income by 1.5 per cent, and assumes they will have to make 4 per cent efficiency savings, but Birmingham said it expected its overall income to drop by nearly 2 per cent.
Liverpool expects a 1.4 per cent overall income cut, but said it would have to make efficiency savings of at least 7 per cent, possibly up to 9 per cent.
Liverpool Women’s assistant finance director Tony Rowan said: “We’ll do whatever we can, and if that means lobbying the DH, that’s what we’ll do.”
General hospitals could also see above average cuts to maternity income. Jane Tomkinson, director of finance and compliance at Countess of Chester NHS Foundation Trust, said it would lose £600,000, or 4.5 per cent, of maternity income.
The news came as health secretary Andrew Lansley gave a speech backing a move to single up-front payments for entire packages of maternity services, saying the current system encouraged “reactive” antenatal care.
Speaking to the Nuffield Health Trust Summit last week, Mr Lansley backed the expected move in 2012-13 to “pathway based” tariffs for maternity services, which could see hospitals paid a fixed up-front sum for a woman’s entire maternity care package, based on an initial risk assessment of the pregnancy.
He said: “The current system pays for activity, encouraging a reactive approach that increases the chances of last minute interventions.
“Clinical responsibilities will hopefully override this, but why should the tariff and clinical quality not coincide?”
Mr Rowan said the pathway tariffs provided “the opportunity to take a fresh look at how maternity services are reimbursed and to potentially capture all the costs of providing the service”.
Sean O’Sullivan, head of policy at the Royal College of Midwives, said “in principle” there were some advantages to the pathway tariff approach. But he questioned how the system would adjust for cases where a woman’s risk profile changed during the pregnancy.
A DH spokesperson said: “The reduction in maternity income is as a result of prices being brought into line with underlying costs. The changes to the maternity tariff have been staggered over two years to reduce their impact.”