Marginal Rate Emergency Rule (MRET) - Investing the Retained Funds:

The marginal rate emergency rule (MRET) was introduced in 2010/11 in response to a growth in emergency admissions in England that could not be explained by population growth and Accident & Emergency (A&E) attendance growth alone. This growth in emergency admissions was made up primarily of emergency spells (a patient’s time with the provider from admission to discharge) lasting less than 48 hours.

MRET sets a baseline value for income from emergency admissions for each provider. For emergency admissions above this baseline, the provider receives 70% of the normal price.

The 30% of the value of the emergency admissions above a provider’s baseline that is retained by the commissioner must be spent on managing the demand for admitted emergency care.

For planning purposes East Riding of CCG has agreed a notional value to be retained from York Teaching Hospitals NHS Foundation Trust in relation to MRET of £183,380. The exact value will be determined by the level of non-elective activity undertaken in 2015-16.

Discussion and engagement around the reinvestment of these retained funds has been undertaken at the System Resilience Group (In line with the National guidance).

Plans to invest the retained £183,380 have been developed across the following schemes:

• Referral Support Services to reduce demand upon planned care services and ensure timely long term condition management to reduce unplanned clinical deterioration
• Enhancing community diabetes services within the Bridlington locality to support individuals to develop increased knowledge of their clinical condition providing increased opportunities to self-manage / seek medical intervention before their condition deteriorates to the point of requiring hospital admission
• Programmes to ensure that the current level of primary care services are maintained across Bridlington