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The National Tariff. Ric Marshall Director of Pricing. 2012 Act splits price setting role between NHS England and Monitor. NHSE leads on:. Monitor leads on:. Scope and design of currencies Variation rules to National Tariff currencies. Pricing methodology

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The National Tariff

Ric Marshall

Director of Pricing

2012 act splits price setting role between nhs england and monitor
2012 Act splits price setting role between NHS England and Monitor

NHSE leads on:

Monitor leads on:

  • Scope and design of currencies
  • Variation rules to National Tariff currencies
  • Pricing methodology
  • Regulated prices
  • Local modifications
  • Rules for local pricing and non-tariff pricing

Close working and agreement


Monitor’s Price Setting Role

Our price setting role has potential to bring significant benefits to patients

  • Tariff setting not just a method for allocating funds:
  • Signalling financial implications of decisions can influence behaviours of commissioners and providers…
  • …and, in turn, improve quality of outcomes for patients at the same or lower cost
not all prices use a national set price
Not all prices use a National set price….
  • Local determined prices are:
    • Local modifications – increases in national prices for services that are uneconomic for structural reasons, which must be approved by Monitor
    • Local variations – adjustments to national prices or currencies that are agreed by providers and commissioners, and must be published
    • Local prices – locally negotiated prices for services that do not have national prices, including some services with national currencies
  • Must adhere to the rules set out in the 2014/15 National Tariff
  • Prices for ambulance services contracted by commissioning organisations will follow these rules
reviewing urgent and emergency care
Reviewing Urgent and Emergency Care
  • Monitor is currently reviewing models of payment for urgent and emergency care
  • Early Findings:
    • High levels of fixed and semi-fixed costs regardless of demand because of required capacity – reducing demand doesn’t reduce costs
    • Variety of cost structures across the components of urgent and emergency care
  • Emerging Themes for Reform
    • Better coordination across providers to improve outcomes
    • Earlier intervention to reduce demand for emergency care
    • Recognition of the need to maintain a level of coverage and the fixed costs associated
    • Local discretion to design models that are responsive to the needs of local populations
    • Improving quality of data
the pricing timeline

The Pricing Timeline

Early 2014

Spring 2014

Summer 2014

Autumn 2014

Draft long-term strategy for payment design

Policy Forward Look

Final long-term strategy



  • National Tariff Document for 2015/16
  • 2015/16 National Tariff Methodology Discussion paper
  • Tariff Engagement Documents
  • National Tariff Document Statutory Consultation



Publication of 2012/13 PLICS pilot

Costing Direction of Travel

Costing Guidance for 2014


Start ofpricing case management and local determined prices