Question to the Department of Health and Social Care:

To ask Her Majesty’s Government what assessment they have made of the impact of giving priority to new patients over return patients, as proposed in the consultation on the 2017–18 and 2018–19 National Tariff Payment System, by transferring up to 30 per cent of the current payment for follow-up appointments to new appointments.

The proposals in the consultation that relate to reducing the outpatient follow-up price to increase the first attendance are aimed at incentivising the reduction of clinically inappropriate follow-up appointments. It is recognised that not all services are run in the same way and this is why not all follow-up prices were subject to a 30% reduction. Based on an assessment of the specialties, a 10% or 20% percent reduction was applied where appropriate. The services in the 30% category are in the main, surgical, where follow-up rates vary considerably and some may be inappropriately high. In response to sector feedback NHS Improvement (NHSI) made changes to the categorisations before publishing the consultation. If there are pathways within specialities that may be adversely affected, NHSI will consider further guidance to providers and commissioners on the basis of responses to the consultation which closed on 6 December.

If providers and commissioners believe that the funding as described in the national tariff is not sufficient to support a service, and the commissioner does not have adequate community provision in place, then the national tariff allows providers and commissioners to agree variations that will allow for the correct provision of care. This could involve agreeing changes to prices, or the way that care is funded. NHSI and NHS England will look at new patient-centred ways of contracting healthcare and are working closely with providers and commissioners to ensure that they allow for care to be delivered in a more joined up way between healthcare providers.