Agenda item

Sharon Morrow, Chief Operating Officer Barking and Dagenham CCG presented the briefing on the national tariff payment system for 2014/15.  NHS England and Monitor are responsible for setting the NHS payment system and they had published the national tariffs for 2014/15 There had been a period of consultation with commissioners and providers prior to publication.  The tariff deflator of -1.8% had been applied to mental health service contracts. 

Ms Morrow advised that whilst Monitor recognised the challenges being faced by providers and commissioners in transforming patterns of care and improving operational efficiency, they still believed that there were opportunities to improve care and safety by more efficient use of resources and had required providers to make 4% productivity improvements in 2014/15.  It was expected that productivity improvements would be made through operational efficiencies. 

John Atherton, Head of Assurance North Central and East London, NHS England, advised that the deflators had caused a range of discussions across both acute and non-acute services, but the NHS, like much of the public sector, had been charged by the Government to make saving year-on-year.  The decisions were taken at a national level and it is that settlement that NHS London then had to implement.

Councillor Carpenter asked for a candid response to the impact and difference in services that the users would see as a result in the cuts in tariff.  Sharon Morrow responded that as this was a ‘block contract’ the Trust was putting together plans to achieve cost savings through back-office efficiencies and added that she had not been made aware of any effects on patients. 

Councillor Turner commented that he was a little sceptical that such a level of cut could be found for back office efficiencies as the public sector has been undergoing cuts for a number of years and there was unlikely to be areas that could be trimmed further without impacting on service delivery.

Dr Burgess advised that each scheme has to be considered by a panel, which included clinicians, to make sure that savings do not affect the quality of patient care. 

Jacqui van Rossum, Executive Director Integrated Care (London) and Transformation), NELFT, commented that from 2016 there would no longer be ‘block contracts’, which could impact on savings options in the future and could affect service parity across London.

Anne Bristow added that it would be interesting trying to make savings whilst at the same time the ‘Closing the Gap’ programme had increased demands.

The Board wished to record its concerns in regards to the tariff provision, which equated to a funding reduction, and the felt this was not supportive of the policy of achieving parity of esteem’ between mental health and physical health provision.  The Board also noted that this could be further exacerbated by the disparity between acute and non-acute service availability.  The Board also made note of the safeguarding implications and costs following on from the Francis report.

Accordingly, the Board asked the Mental Health Sub-Group monitor this closely and escalate issues to the Board if necessary.