Retained Threshold Funds


Retained Threshold Funds (Marginal Rate Emergency Rule)

The NHS actively promotes the sharing of responsibility for managing the care of patients in the most appropriate setting and the prevention of avoidable unplanned hospital admissions. To support this a contracting mechanism was introduced in 2010-11 in response to a growth in emergency admissions which exceeded that which could be explained by population growth and A&E attendance growth alone.

This mechanism, the Marginal Rate Emergency Rule, has a twofold purpose:

  • firstly, to incentivise lower rates of emergency admissions
  • secondly, to stimulate providers to work with other parties in the local health economy to reduce demand for emergency care

The marginal rate rule sets a baseline for emergency admissions at a provider. A provider is then paid 30% of the national price for any increases in the value of emergency admissions above this baseline. The 70% that is retained by Commissioners is required to be expended on managing the demand for emergency care.

Newham Clinical Commissioning Group (CCG), in accordance with the guidance, will be investing all the retained funds in the delivery of Integrated Care. This will provide a valuable contribution and support the CCG in its plans to reduce emergency admissions.