To account for the total spend to date on NHS England’s proposals for changing the organisation of congenital heart disease (CHD) services is challenging, given the lengthy timeframe and the number of organisations involved.
NHS England has spent £808,039 between August 2015 and January 2017 developing its proposals for implementing the new CHD standards including running the consultation on the draft standards and service specifications for congenital heart disease services and preparing for and launching the current consultation on implementing the standards for CHD services for children and adults in England.
In terms of the projected total cost for implementing the proposed changes and meeting the standards, we understand from NHS England that many of the costs of providing services which meet the new standards can be considered to be already within tariff funding because the standards describe ways of working and staffing levels that are already business as usual in a number of trusts.
Trusts are paid for CHD services through tariff, which ensures that the money received is linked to patient activity. NHS England expects activity within CHD services to rise, resulting in higher income for provider trusts. We understand from NHS England that the cost of meeting the standards will be affordable to providers from within that higher income. In addition it is likely that there will be some economies of scale for providers linked with providing a higher volume of activity.
Growth in activity is driven by an increasing population, increased longevity for CHD patients and advances in clinical practice. This is unaffected by the proposals on which NHS England is consulting. NHS England will fund these additional costs, in line with national tariff and local price arrangements, from within the notified annual increase in the allocation for specialised services.