NHS England and NHS Improvement believe that in 2016/17, the NHS must focus on
eliminating the provider deficit alongside the delivery of safe care and NHS constitutional
obligations. Changes in currency design inevitably result in changes in how money flows from
commissioners to providers. Given the focus, NHS providers need a stable financial baseline
to plan how they will deliver their part of this collective effort. Now is not the time therefore to
introduce any measures (such as HRG4+) that will increase provider financial uncertainty and
potentially hinder this objective.
We do understand that some prices no longer reflect costs well, and continue to believe that
HRG4+ is an improved currency framework. We now intend to introduce HRG4+ in 2017/18
and will continue to work with clinicians on the accuracy of cost collections to improve how we
set price levels. In 2016/17 the sustainability fund is being set up which will be used to support
providers delivering important services such as nuclear medicine.
For nuclear medicine, as all other services, we will base 2016/17 tariff prices on the Enhanced
Tariff Option prices used by most providers in 2015/16. We will also be publishing the work to
date on the 68 nuclear medicine currencies to supplement the 2016/17 national tariff by 31
We understand the frustrations that many clinicians who have been involved in the
development of HRG4+ will feel but equally we hope clinicians understand that this decision
was not taken lightly and was in the interests of the NHS as a whole. We hope therefore that
clinicians will continue to support our efforts to improve pricing mechanisms and will appreciate
that only from a more stable and sustainable financial platform will we be able to use pricing
incentives effectively in the NHS to improve patient care.
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