NHS Providers response to the payment system reform proposals for 2019/20

We welcome the opportunity to engage on the outline proposals for the 2019/20 tariff, and note the number of occasions in recent months where providers' views have been sought. Unlike the last round of engagement, which was for a two year tariff, this year's proposal cover a single financial year. We support this reasonable and pragmatic approach, given the need to finalise 2019/20 proposals in a timely manner, and to coordinate the focus of the new financial framework with the aspirations of the forthcoming NHS long term plan. We would also like to take this opportunity to note that NHS Improvement and NHS England have led by example in working jointly to produce these proposals. We look forward to further opportunities to engage with them as they develop the proposals/

We welcome the national bodies' intentions to address challenges within the current national tariff payment system and to develop a payment model that shares incentives across providers and commissioners to reduce avoidable A&E attendances; and more fairly reflect the costs incurred by trusts.

However many of the proposals are only outlined in general terms at this stage and it is difficult to predict with certainty from the information provided what their impact will be on providers. We also note that some of the measures - particularly changes to payments for emergency care - represent a significant shift from the past and it would be helpful to know whether they are designed for the long term or just for one year. 

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