Correspondence

FT Bulletin April 2015

Published 22 April 2015

Applies to England

1. For action

1.1 Please submit your local prices via our new portal by 30 June 2015

You can now submit your local prices via our new online portal. Please submit yours by 30 June using the new local prices template, which replaces the one you previously used.

The principles and rules for agreeing local prices with your commissioners are set out in subsections 7.1 and 7.4 of the National Tariff Payment System.

1.2 Patient level cost collection: consider our recommendations before your 2014/15 collection

We have published a series of recommendations based on the findings of the 2013/14 Patient Level Information and Costing Systems (PLICS) data collection for admitted patient care.

If you are involved in the production of cost information, please consider these so that you can implement any changes before the 2014/15 PLICS collection starts.

We will publish more details on the 2014/15 PLICS collection in May 2015.

1.3 Freedom to speak up: share your views with the Department of Health

The Department of Health (DH) would like your views on how to implement recommendations made in the ‘Freedom to speak up’ review that will help create an open and honest reporting culture in the NHS.

You and your teams can respond online or via email until 4 June.

1.4 Please publish your clinical quality indicators: a reminder to acute foundation trusts

There are 7 clinical quality indicators (CQIs) for emergency departments designed to promote safe, efficient practice; help you identify where the key blocks to flow are, and identify specific areas for quality improvement.

You are required to make monthly CQI data publicly available and intelligible to patients and the public but we have noticed that some foundation trusts are either not publishing their data or are just putting a link to Health and Social Care Information Centre (HSCIC) on their website. This means that the public may be presented with a spreadsheet which is difficult to navigate, contains no commentary and where the data is 3 months out of date.

We will be checking that the latest information is available on your individual websites and that your data is presented in line with the original guidance.

Please can you ensure that you have published your latest CQIs by 30 June 2015 and continue to update these going forward.

2. For information

2.1 An updated well-led framework has been published

We have updated the well-led framework so that the characteristics Monitor, the Care Quality Commission (CQC) and the NHS Trust Development Authority (TDA) use to define a well-led organisation are now identical.

The well-led framework replaces the quality governance framework and board governance assurance framework. Please use the framework as the reference for structuring your governance reviews.

Find out more about the changes to the framework and what they mean for you.

2.2 Monitor’s risk assessment framework: what has changed?

We have updated the risk assessment framework (RAF) following your feedback on our proposals. Changes include:

• introducing the new access measures for mental health as governance proxies
• specific requirements for providers of high security psychiatric services
• an additional trigger for investigating financial risk
• general updates to bring the framework up to date with recent policy changes

We have also published separate guidance on governance over audit, assurance and accountability, which replaces some of the provisions previously included in Monitor’s audit code for NHS foundation trusts.

2.3 New guidance on the integrated care licence condition

We have published new guidance on the integrated care licence condition following feedback to our consultation. It explains:

• our expectations of you in relation to the integrated care licence condition
• how to avoid breaching the condition
• when we may need to take enforcement action

Please read this alongside our enforcement guidance so that you and your colleagues can be confident you are acting within the licence condition.

Anyone can contact us for informal advice, or to make a formal complaint about a provider’s behaviour relating to integrated care in the NHS. Complaints can be made by an individual, healthcare provider, commissioner, patient group or representative body.

2.4 How will your feedback shape the way NHS services are costed?

Thank you for your contributions to our consultation on improving the costing of NHS services. We have reviewed our costing proposals for 2015 to 2021 based on this feedback.

You can read more about the areas of work that are scheduled for 2015 in our response to your feedback.

2.5 Changes to delayed discharge payments under the Care Act

Changes to delayed discharge payment arrangements have been made under the Care Act. These came into effect on 1 April and are outlined in the ‘Care and Support Statutory Guidance.’ This technical guidance is also available to provide further information on the changes.

If you have any questions on the Care Act please email Charlotte Buckley at the DH, carebillreform@local.gov.uk. If you have a query on the technical guidance please email Paul Steele at NHS England, unify2@dh.gsi.gov.uk.

2.6 Operational resilience funding: your questions answered

Monitor, NHS England and the TDA have published this guidance to answer a number of queries submitted from both providers and commissioners on operational resilience funding for 2015/16.

2.7 The Government Banking Service is moving to a single bank approach

Royal Bank of Scotland (RBS) will soon provide all Government Banking Service (GBS) bank accounts in the health service. Finance directors should have received a letter in January from GBS explaining the move to a single bank approach.

The new arrangements are expected to take effect this financial year, as close to 1 October 2015 as possible.

If you foresee any issues or risks with this transition, particularly if your accounts are currently with CitiBank, please get in contact with your relationship manager at Monitor.

2.8 Updated guidance for foundation trusts considering a significant transaction

We have updated our guidance to help foundation trusts considering a significant transaction. This includes updates on the timing of council of governor elections for foundation trusts undertaking a merger or acquisition.

2.9 What governors told us in our recent survey

We have now published the findings of our third survey of governors. Governors told us about areas that have improved and where further support is still needed, including:

• that their role could be strengthened by broadening the membership of the council
• they would welcome further help to improve their ability to hold non-executive directors to account in practice
• that they greatly appreciate both induction and follow-on training

2.10 CMA order on financial incentive schemes

The Competition and Markets Authority (CMA) has introduced a new legal order on financial incentive schemes in healthcare. This prohibits organisations which operate independent and private healthcare facilities, from offering incentives to clinicians who give preference to those facilities when treating or referring patients for treatments or tests. The order also prohibits doctors from requesting or accepting such incentives.

If your organisation has a private patient unit then this order applies to you so please familiarise yourself with its contents.

2.11 2015/16 contract negotiations for specialised commissioning

As a consequence of the national enhanced tariff offer, 2015/16 contract negotiations for specialised commissioning have been delayed with initial commissioning offers made on or just before 31 March 2015.

Feedback from specialised commissioners and providers, particularly over the last couple of days, has been that progress is being made with contract negotiations and that a short delay in the date at which formal arbitration is entered in to would be helpful for ensuring the signature of robust, agreed contracts for specialised services.

NHS England, NHS Trust Development Authority and Monitor have therefore amended the timing of the arbitration process for 2015/16 contracts for specialised commissioning.

The revised arbitration timetable for specialised commissioning is as follows:

17 April (noon)	existing deadline for NHS trusts / specialised commissioners that have not signed contracts to submit arbitration papers
20 April (noon)	NHS trusts / specialised commissioners that have not signed contracts to submit a joint statement explaining the action they will jointly take to ensure contracts are signed by Monday 27 April at 9am
27 April (9am)	NHS trusts / specialised commissioners to enter into arbitration where specialised commissioning contracts are not signed. Paperwork will need to be submitted by this deadline in the format described in the dispute resolution process guidance. Paperwork submitted after this deadline will not be considered
30 April / 1 May / 5 May / 6 May / 7 May	Independent arbitration panel to meet
8 May (5pm)	Letters to all parties confirming outcome of arbitration decision

This timetable also applies to foundation trusts who opt to make use of the dispute resolution process.

2.12 Monitor’s new Director of Pricing

Toby Lambert has taken over as the Director of Pricing at Monitor. Toby was previously Monitor’s Director of Strategy and Policy. Ric Marshall, who has been heading up Monitor’s Pricing team, will stay on throughout 2015 to support this year’s payment cycle.

Toby looks forward to meeting many of you over the coming weeks and months as we work with NHS England to develop proposals for the 2016/17 national tariff.

3. Events

3.1 Monitor and HFMA Annual Costing Conference 2015: Direction of Travel

30 April 2015, London

For: Costing practitioners.

Why attend? To hear about the latest developments in costing methodologies and guidance.

On the day:

• hear about Monitor’s plans for costing, and how we will support the new models of care set out in the Five Year Forward View
• there will be plenary and workshop sessions on important topics covering costing from an acute, mental health, community and strategic point of view

We will be speaking at this event, and delegates can also visit our stand to speak to our costing team.

Learn more and book your place.

3.2 Monitor and NHS Providers Foundation Trust Non-Executive Director Induction Programme

27-28 April 2015, London (There are still a few places available)

For: Non-executive directors (NEDs) of foundation trusts.

Why attend: To learn specific information about the foundation trust sector that will help you prepare for your role.

This programme is primarily for foundation trust NEDs. However, if you are a NED of an applicant NHS trust please get in touch to discuss as this may also be relevant to you. This this is a 2 day programme so please make sure you can attend both days before signing up.

To book your place, visit NHS Providers’ website.

If you have any queries, please contact: Carolyn May, Monitor’s Senior Development Adviser on 020 3747 0083 or Kim Hutchings, Head of Development and Engagement at NHS Providers on 020 7304 6881.

3.3 HFMA NHS Payment System Conference

13 May 2015, London

For: Finance directors and finance managers with a role or interest in the development and operation of the NHS payment system.

Why attend? This conference aims to provide both a strategic overview and the opportunity for technical discussion on current and future issues relating to the NHS payment system.

On the day:

• join a Q&A session led by Monitor and NHS England
• hear how the payment system can support the delivery of the NHS Five Year Forward View
• look at the priorities for the 2016/17 National Tariff
• learn from pilots about the payment system and new care models
• explore how improving costing can help deliver better prices
• discuss urgent and emergency care reimbursement
• examine local variations

Book your place.

3.4 Board Induction Day

25 June 2015, London (Monitor offices)

For: Newly appointed chairs and chief executives of NHS foundation trusts.

Why attend? Monitor runs these sessions for those who have not had prior experience of Monitor’s authorisation process.

On the day:

• learn about Monitor’s role, including an overview of pricing and competition
• find out what the NHS foundation trust legal framework looks like
• explore the regulatory regime, including the risk assessment framework and enforcement processes
• learn about quality and quality governance
• learn about foundation trust governance, including working effectively with governors
• hear about current issues in the NHS

Places are limited and will be on a first come first served basis so please only register if you are a chair or chief executive of a foundation trust.

To enquire about a place or to be kept informed of future dates, please email mel.baldwin@monitor.gov.uk.

3.5 Network and Sharing Day

8 July 2015, London (Monitor offices)

For: Established foundation trust chairs and chief executives who have already attended our Board Induction Day and / or have been in post for at least one year.

Why attend? To meet with our Development Team and other chairs and chief executives to network and share the challenges you experience.

On the day:

• discuss your current challenges with senior Monitor staff in an informal and non-regulatory setting (includes members of Monitor’s Executive team as well as relationship directors)
• hear what Monitor regards as the most important topical issues, including sharing identified good practice where relevant
• build your awareness of tools or guidance that we think it may be helpful for organisations to use
• network and make new contacts among peers

Places will be allocated on a first-come, first-served basis to a maximum of 20 participants to ensure this is a high quality and interactive session.

To book your place please email mel.baldwin@monitor.gov.uk.

4. External updates

4.1 Changes to drink and drug driving laws and the impact on NHS frontline staff

The following changes to drink and drug driving laws came into force on Friday 10 April:

• drink drivers will no longer be entitled to request a blood or urine sample when their breath specimen is less than 51mg/100ml; the police will however retain the right to test blood or urine should they wish to do so
• a wider range of registered healthcare professionals will be able to advise whether a person is impaired by drugs during the investigation of a person’s driving ability
• registered healthcare professionals will also now be able to take evidential blood samples at hospitals in addition to the existing provision for police stations

The 10 April commencement date was set in a Statutory Instruments Order following the De-Regulation Act 2015 and will apply consistently across all forms of transport including road, rail, maritime and aviation.

4.2 New overseas tariff for non-European Economic Area (EEA) countries

A new overseas tariff for patients from non-European Economic Area (EEA) countries came into effect on 6 April 2015.

Please invoice chargeable patients 150% of the national tariff (or equivalent). In addition you will be eligible to receive half the value of invoices issued to these patients from your commissioner(s).

For more information, read this guidance on overseas visitor hospital charging regulations.

If you have any questions please contact the Visitor and Migrant NHS Cost Recovery Programme NHSCostRecovery@dh.gsi.gov.uk.

4.3 Increases to optical voucher values and hospital eye service charges

NHS optical voucher values and hospital eye service charges have increased as of 1 April 2015.

The DH has produced a note and directions on these increases for those dealing with general ophthalmic services and the hospital eye service.

5. Get in touch

5.1 Our latest job opportunities

For more information or to apply, please visit our recruitment website joinmonitor.com.

5.2 Queries or feedback

If you have any queries about the information in this bulletin, please contact your relationship manager at Monitor.

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5.4 Publications

All of our publications are available to download from our publications section.