2019/20 payment reform proposals

We proposed a number of changes to the payment system in 2019/20 and sought feedback on our proposals.

Payment reform proposals

In partnership with NHS England, in October 2018 we set out some of the principal proposed changes to the payment system in 2019/20. This included changes to:

  • duration of the tariff
  • payment approach for emergency care
  • market forces factor (MFF)
  • maternity payment pathway.

To support these proposals, NHS Digital published a 2019/20 engagement grouper.

We held the following webinars to set out and discuss proposals in more detail:

There was a survey to collect feedback on the proposals, which closed on 29 October. We will use the feedback to finalise the proposals we include in the statutory consultation on the next tariff.

Please contact pricing@improvement.nhs.uk if you have any questions.

Payment system reform proposals for 2019/20 PDF, 436.6 KB

Principal proposed changes to the payment system in 2019/20.

Draft price relativities workbook XLSX, 698.0 KB

Draft price relativities for the 2019/20 national tariff and a means of providing feedback on them.

Responding to our proposals PDF, 266.1 KB

Guidance on how to provide feedback on our proposals.

Word version of online survey DOC, 105.5 KB

A Word version of the online survey. The survey closed on 29 October.

Market forces factor review and update

One of the most significant proposed changes is an update to the market forces factor (MFF).

The market forces factor (MFF) estimates the unavoidable cost differences between healthcare providers, based on their geographical location. Each NHS provider is assigned an individual MFF value. MFF values are used to adjust national prices and commissioner allocations.

The MFF has not been updated for almost 10 years. The current MFF is based on primary care trust (PCT) boundaries, which no longer exist. In addition, the underlying data used to calculate the MFF has changed since it was last reviewed.

The documents below give more details of the review and proposed updates, as well as the models used to calculate the proposed MFF values.

Market forces factor review and proposed updates PDF, 1.1 MB

More detail about the proposed changes to the market forces factor.

Proposed MFF values workbook XLSX, 108.7 KB

Lists providers' MFF values after the proposed method and data updates.

Supporting documents PDF, 4.5 MB

Contains the final reports from the independent research commissioned to support the MFF review, from the University of Aberdeen, The King's Fund and Frontier Economics.

Models used to calculate proposed MFF ZIP, 15.7 MB

These files contain the models used to calculate each of the elements included in the proposed MFF values.

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