We welcome the opportunity to engage on the tariff proposals for a second time. Throughout the development of the tariff there has been reasonable informal engagement with trusts and the wider NHS, which has enabled trusts to give constructive feedback. NHS Providers supports the collaborative approach NHS Improvement continues to take in sourcing providers to input into the impact assessment. Regular communication, through email bulletins and workshops, has been appreciated.

Nevertheless, the timescales between consultation and implementation have slipped back compares to previous tariff consultations. While we appreciate there were some delays to the proposals because of the announcement of the five year funding settlement in the summer, we are disappointed over the shortened engagement timescales. This will make implementation much more difficult than in previous years, particularly with the radical changes proposed to urgent and emergency care and mental health services. Ideally, we would have liked to have seen more flexibility around implementation and lead-in times. In addition to this, providers would have welcomed greater detail in the October consultation around certain proposals, such as the mental health blended payment system, as this may have helped lay the groundwork for later negotiations.