We have consulted widely with our members on the proposals proposals put forward by the Department of Health to:

• remove the possibility for the objection mechanism to be triggered by 51% of providers by 'share of supply'
• increase the threshold for the objection mechanism from 51% of providers and commissioners (by number) to between 66% and 75%.

We strongly oppose the changes put forward, as they will have a material impact on frontline NHS providers and will serve to remove the only formal opportunity available to NHS provider leaders to raise concerns about their ability to deliver the right quality of care.

We call on the Department of Health to:

• maintain the possibility for the objection mechanism to be triggered by 51% of providers by 'share of supply';
• maintain the volume threshold for the objection mechanism at 51%;
• review the definition of relevant providers before any further changes are proposed to the objection mechanism; and
• provide further assurances about how the sector is consulted on national tariff proposals in future.