Fines for the non-achievement of performance targets have effectively increased by 60 per cent under new rules announced on Thursday.

The Strengthening Financial Performance and Accountability document released by NHS Improvement and NHS England said providers would no longer be fined for missing national access targets on A&E, elective care and cancer – but would instead miss out on part of sustainability and transformation fund bailout money if they miss an agreed “performance trajectory”.

Thirty per cent of the £1.8bn fund, £540m, is linked to hitting these bespoke targets.

NHS Improvement figures show providers were fined £308m by commissioners in 2015-16.

The full total for the year was £502m but £194m of that was reinvested back into the provider sector.

Providers will only be able to access the STF if they satisfy financial targets set out by NHS Improvement. Once that is achieved they get 12.5 per cent of their funding for achieving their A&E target, 12.5 for achieving their elective referral to treatment time target and five per cent for achieving the 62 day cancer access target.