Department of Health gender pay gap revealed

Women working at the at the Department of Health earn up to 14 per cent less than men an hour – despite women making up two-thirds of its workforce.

The DH has published a report on its gender pay gap alongside other Whitehall departments, which reveals the scale of the challenge to achieve pay equality for women in the civil service.

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Guidance on overseas visitors hospital charging regulations

Guidance, from the Department of Health, for NHS bodies who need to make and recover hospital charges from overseas visitors.

See also Overseas patient upfront tariff 2017/18.

Exclusive: One in four hospital trusts routinely pay suppliers late

More than a quarter of hospital trusts are now routinely delaying payments to their suppliers because of cash flow problems, analysis by HSJ reveals.

Data collected from annual reports since 2014-15 shows a threefold increase in acute providers paying more than half their invoices late, with dozens of trusts reporting a steep rise in late payments.

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Revealed: 'Broad principles' agreed for major pay reform

• Informal talks between Agenda for Change unions and NHS Employers agree on principles for reform
• Lack of money for pay rise meant talks stalled but budget could bring new impetus
• Increment reforms wanted by both sides but government ‘sleight of hand’ could be ‘toxic’ to a deal

Unions and employers have agreed ‘broad principles’ for reforming the terms and conditions of more than a million NHS workers, HSJ has learned.

The amendments to the Agenda for Change pay contract are on hold, pending the budget later this month. Senior sources have told HSJ if the Treasury releases funds for a “significant” pay rise for NHS staff, negotiations over reforming terms and conditions could start within months.

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Revealed: FT redundancy pay outs fall by more than a quarter

The amount spent on redundancy payments by foundation trusts has fallen significantly over the past three financial years, HSJ analysis reveals.

Data collected from FTs’ annual accounts shows that the total spent on redundancies fell from £80m in 2014-15 to £57m in 2016-17.

The fall could reflect the government’s scrutiny of the size of exit payments and changes to payment rules, the union Managers in Partnership said.

The national totals are disproportionately made up by small number of trusts. Of the £208m spent by FTs on redundancy payments over the three years, £55m was by just 10 trusts (see table).
Of these trusts, seven are mental health providers, two are acute providers in the North East and one is a teaching hospital trust in Yorkshire. Subscribers can download and explore the full dataset here.

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Lifting the cap the fiscal and economic impact of lifting the NHS pay cap

Workers in the NHS have experienced a seven-year pay squeeze, with a two-year pay freeze from 2011/12, followed by pay capped at 1 per cent for the following five years. This has significantly eroded the value of pay in the NHS; pay for a band 5 nurse is £3,214 or 10.1 per cent lower today than pay for the same role in 2010/11.

In this briefing, from the Institute for Fiscal Studies, we examine the fiscal and economic impact of two alternative scenarios for NHS pay over the next two years; increasing pay in line with Consumer Price Index (CPI) inflation, and a ‘catch-up’ rate of increasing NHS pay in line with private sector earnings plus 1 per cent.

Mandatory training costs 2017

This paper, from the Academy of Medical Royal Colleges, sets out the mandatory costs of training involved in College enrolment fees, examination costs and GMC fees. It also provides links to College websites where information will be available on further professional development and additional non-mandatory costs.

It has been compiled to help pre-specialty doctors make fully informed career selections, with a clear understanding of the mandatory costs of their future training pathway. It has been produced with the combined information and support of the Royal Colleges via the Academy of Medical Royal Colleges.

Towards an effective NHS payment system: eight principles

This report from the Health Foundation sets out eight principles for a future payment system, primarily arguing that clarity of purpose is required to refocus the system’s many objectives. It argues that that now is the ideal time to review the system, with vanguards and STPs already changing the way that care is delivered, while a two-year fixed payment by results tariff offers space for reform.

NHS staff health & wellbeing: Commissioning for Quality and Innovation (CQUIN) 2017-19 Indicator 1 Implementation Support

This supplementary guidance from NHS England provides clarification on the criteria set out in the indicator specifications for the 2017-19 Health and Wellbeing CQUIN and supports implementation of each CQUIN indicator by providing tools and resources.

When the price isn't right: how cuts in hospital payments added up to the NHS deficit

NHS hospitals and other services ended the financial year 2016/17 with an underlying deficit of £3.7 billion. That is to say: they had £3.7 billion less reliable cash coming in than they had going out.

The answer, in this briefing from the Nuffield Trust, is surprisingly simple: hospitals are paid for each patient they treat, and the price they receive is set by a national tariff listing thousands of common procedures or types of care. But the prices on this list have been cut in real terms every year since 2009/10, and most years in cash terms too.

This means that a hospital will be given just £937 in cash this year to treat a patient they would have received £1,000 in cash to care for in 2009/10 – the green line on our graph. Factor in eight years of inflation, and that £937 is more like £760 (the blue line).

Managing the costs of clinical negligence in trusts

According to this report from the National Audit Office, the government needs to take a stronger and more integrated approach if it is to rein in the increasing cost of clinical negligence claims across the health and justice systems. It finds that over the last ten years, spending on the Clinical Negligence Scheme for Trusts has quadrupled from £0.4 billion in 2006-07 to £1.6 billion in 2016-17, while the number of successful clinical negligence claims where damages were awarded has more than doubled, from 2,800 to 7,300.

Commissioning policy: Reimbursement of expenses for living donors

This is an NHS England policy designed to inform healthcare professionals and commissioning authorities about the principles and processes that underpin financial reimbursement for living organ donors.

New charging regulations for overseas visitors

From Monday 23 October 2017 new charging regulations will apply for overseas visitors receiving healthcare in England.

The regulations place a new legal obligation on NHS providers to charge for non-urgent treatment in advance, once you have established whether a person is eligible. Commissioners will be implementing these arrangements with all providers of NHS-funded community and secondary care including independent providers.

When charges apply, the relevant body must make and recover charges in advance of providing NHS services, unless doing so would prevent or delay the provision of immediately necessary or urgent treatment.

Integrating care: contracting for accountable models NHS England

NHS England has published information on contractual arrangements for accountable care organisations.

This package clarifies how accountable models may be contracted for, how local areas would approach procurement questions and the application of the new Integrated Support and Assurance Process, run by NHSE and NHSI in relation to the award of all novel or complex procurements by commissioners. It sets out the funding model including the details of integrated budget approaches, a new Improvement Payment Scheme to replace current incentive schemes and gain/loss sharing across the local health economy to align incentives. Finally, the package describes implications for the commissioning system of new models of whole population provision.

Immigration health surcharge: removal of assisted conception services

Amendments to the NHS (Charges to Overseas Visitors) Regulations 2015 were introduced into Parliament on 19 July 2017.

As a result, from 21 August 2017, assisted conception services will no longer be included in the scope of services available for free for those who pay the immigration health surcharge. CCGs should update their online and publicly available policies in this area, to ensure potential users of these services are aware of the changes. Further information can be found in the explanatory memorandum for these regulations. 

Guidance on overseas visitors hospital charging regulations

Updated guidance on making and recovering charges for NHS hospital treatment from overseas visitors not exempt from charge.

Application of HMRC’s IR35 tax rule changes on NHS agency staff: updated guidance

The IR35 tax rule changes, which came into force in April, shifted the responsibility for assessing whether IR35 applies from individuals to providers. NHS Improvement's priority is to help encourage NHS providers to ensure that agency staff pay the correct tax, and following conversations with the sector we've updated and amended our guidance. This is to ensure that there is no ambiguity in what trusts are expected to do.

You should not assume that all agency staff will fall inside IR35; please assess whether or not the IR35 rules apply on a case by case basis. Where there are cases of ambiguity you should seek expert advice or approach HMRC, who also have an easy online toolkit for guidance.

Ambulatory emergency care: reimbursement under the national tariff

This HFMA briefing aims to create a better understanding of the current approaches taken to the recording and reimbursement of ambulatory care. HFMA surveyed its members to establish some basic benchmarking information to see how the guidance is currently applied.

Gender pay gap reporting - what you need to know

From 31 March 2017 it is mandatory for public sector organisations with over 250 employees to report annually on their Gender Pay Gap.

NHS National Tariff Payment System 2016/17

Update on the NHS National Tariff Payment System for 2016/17.