STRUCTURE: Northern Devon Healthcare Trust has announced it needs to redesign its maternity and obstetric services “immediately” as a result of changes to the national tariff.

The trust has just agreed a contract with its commissioners following an arbitration process overseen by NHS England and the NHS Trust Development Authority. The agreement will see the trust and the North, East and West Devon Clinical Commissioning Group split the £2.2m loss as a result of the new maternity pathway payments which were made mandatory for 2013-14.

In a press release Northern Devon claimed the change equated to a 20 per cent cut in funding for the services

Chief executive Jac Kelly said the “loss of this level of income” would “inevitably call for a redesign of services” but said patient safety would be “paramount”.

She added: “The scale of the changes and the fact they have to be introduced immediately isn’t ideal. Some of the changes bring us in line with the model of care in other parts of the country. However, there will be service changes we would otherwise not have been planning to undertake.”

Under national guidance on PbR, organisations were expected to run the maternity pathway payment in shadow form during 2012-13 ahead of its introduction this year. The guidance recognises the changes may have a “major impact” on organisations’ finances due either to the fact the local case mix is different from average or information systems are not sufficiently developed to collect the necessary data. It recommends commissioners and providers should share any gains or losses.

In a press release the CCG said the agreement reached following arbitration includes a payment of £1.1m above tariff for maternity services “while a review is carried out” as well as additional funding for community services in the north of the county. The trust is also losing £1.1m.

John Womersley, the CCG’s northern locality chair, said: “The reality of the current financial climate is that changes are necessary to deliver services within the finances available. The CCG will be working closely with the trust to ensure that the access and quality of services is maintained in this environment.”