2019/20 payment reform proposals

We are proposing a number of changes to the payment system in 2019/20 and are looking for feedback on our proposals.

Payment reform proposals

In partnership with NHS England we've set out some of the principal proposed changes to the payment system in 2019/20. This includes changes to:

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

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

There is an online survey for your feedback on the proposals. There is also a Word version of the survey, available to download below, to help you develop your response. We have published a separate MFF survey on the proposed changes to the market forces factor (see below for more details). Please refer to 'Responding to our proposals' for guidance on how to give feedback. The deadline for feedback is 5pm on 29 October.

On 19 October, we are holding a webinar on the proposed changes to the market forces factor. Click here to register.

We have already held the following webinars:

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

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

Some of the principal proposed changes to the payment system in 2019/20.

Draft price relativities workbook XLSX, 693.7 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 to help you to develop your response. Please do not use this document to submit your feedback.

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.

There is an online survey to give feedback on the proposed changes to the MFF. The deadline for feedback is 29 October.

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.

Word version of MFF online survey DOC, 68.5 KB

A Word version of the online survey to help you to develop your response. Please do not use this document to submit your feedback.

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