Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment he has made of the effectiveness of the Marginal Rate Emergency Tariff (MRET) fund reinvestment in reducing emergency admissions for specialist services pathways such as neuromuscular services; and whether MRET funding is the responsibility of clinical commissioning groups or NHS England.

NHS England and Monitor undertook a review of the marginal rate emergency rule in 2013. The findings from this review informed a number of changes to the operation of the policy. These changes were introduced in 2014/15. The review did not look explicitly at the effectiveness of the marginal rate emergency rule fund reinvestment in reducing emergency admissions for specialist services pathways such as neuromuscular services. However it noted that as specialist activity cannot be demand managed, the effectiveness of the marginal rate to incentivise reducing emergency admissions for specialist services is limited.

Marginal rate emergency tariff (MRET) funding is administered by NHS England. The MRET applies to activity commissioned by clinical commissioning groups and NHS England, though some activity is explicitly excluded from the scope of the rule, such as activity for which there is no national price; and accident and emergency attendances.