Penalty payments for breached targets could be slashed

Checklist analysis has suggested that current changes under discussion could mean a significant reduction in penalty payments for breaching NHS targets.

In 2013, analysis found that the total penalties bill came in at £227 million. The final bill for the 2014-15 year is predicted to be £87 million or less if new rules and a cap are implemented or £117.8 million if fines are left uncapped.

The caps under discussion revolve around new rules that will see trusts fined on a per patient basis for breaching targets. This would mark a significant deviation from the current system that sees trusts fined on the percentage of patients that have had to wait longer than the 18 week cut-off mark.

A cap on penalties of 2.5 per cent of a providers' total monthly revenue could also be introduced in a bid to make the fines more effective. The Checklist analysis found that this would make a dramatic difference to the amount of money trusts could be forced to payout should they miss targets, with cuts of millions of pounds predicted in some cases.

An NHS England spokeswoman told the Health Service Journal: “Arrangements for 2014-15 have been made clearer and simpler and, because of these changes, it is difficult to directly compare the two.

“However, assuming there is no marked change in provider performance between the two years, our broad expectation is that overall sanctions imposed by commissioners will be no higher than in 2013-14 and, in some cases, providers that miss a standard by only a small margin in a particular period may face a lower sanction.”

Meanwhile, Anthony Thompson, a director with Checklist, was keen to highlight the impact of a recently-implemented change – namely the potential introduction of a fine of £5,000 for every patient with a hospital that has to wait more than 52 weeks for treatment following referral.

Mr Thomspon observed that the fine would have a “huge effect”, adding: “If you're a chief executive that's a no-brainer to make sure that those patients do get treated. My sense is that the over 52 [weeks] waiter issue has largely gone away and the £5,000 fine has been quite effective.”