Feature / Implications for tariffs

31 October 2014 Steve Brown

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Image removed.Paul Stefanoski, deputy chief executive and director of resources at Black Country Partnership NHS Foundation Trust and chair of the HFMA MH Finance faculty, agrees that a continuing high error rate suggests ‘we are still some way from a national tariff’.

‘But there is something of a chicken and egg issue here,’ he says. ‘Without the certainty that we will move to a national tariff system, trusts may be focused more on other significant priorities. It is hard to argue for investment in systems, training, staff and time for something that only might happen. Trusts know it is on the horizon, but there are lots of pressures and, for some organisations, this may not be top of the list.’

Mr Stefanoski highlights that the report reflects costing for the 2012/13 submission and cluster activity data from 2013/14. ‘We’ve moved on since then and people will be getting more used to the clustering process,’ he says.

But he believes there are too many uncertainties to translate improvement between the two audit processes so far into a trend. ‘A lot of people have invested in training, but this may not yet be systematic. We need to understand the need for ongoing support for clinicians and the impact of staff turnover on training needs before we can assume we will continue to see improvements.’

Mr Stefanoski insists there are major benefits for the service in developing a rich data source of activity and cost data and that these go beyond the development of a national tariff.

But he suggests this development is in ‘evolution not revolution’ mode and the speed of change is likely to be linked to the pace of change on tariff development rather than these broader benefits.