Funding for Personal Maternity Care Budgets (PMCBs)

Will all types of Personal Health Budgets be available for maternity care?

No. PMCBs will only be available as notional budgets. They will not involve any additional money. CCGs will continue to pay for the services out of the money allocated for maternity services.

With Personal Health Budgets there are three methods of delivery:

  • Direct payments to an individual or his/her representative to arrange and pay for services to meet their personal needs.
  • Third party budgets, where a designated third party has control over the budget and arranges and pays for services on behalf of the individual.
  • Notional budgets, where the individual’s responsible CCG procures services on the individual’s behalf.

The first two of these are not options for a PMCB.

How much will the budget be for each woman?

For the Pioneers launching their work this year, the notional budget will be the relevant National Tariff prices set for 2016/17 for each of the three stages of the maternity pathway.  The price paid for antenatal care, intrapartum care and postnatal care varies depending on the complexity of a woman’s needs and the level of care that she requires.

Prices are subject to review and change for future years. The Maternity Transformation Programme includes work to review the current payment approach for maternity, to assess where any changes might be necessary to the way in which payment is made. This work will take account of different cost structures for different providers in different settings, how well the current payment system is working, and any changes in referral patterns over time that might ensue from making choice work better in maternity services.

2016/17 National Tariff:

Antenatal

Name Tariff (£)
Standard 1,057
Intermediate 1,691
Intensive 2,815

Delivery

Name Combined day case / ordinary elective / non-elective spell tariff (£) Per day long stay payment (£)
With complications and co-morbidities 2,582 363
Without complications and co-morbidities 1,755 363

Postnatal

Name Tariff (£)
Standard 250
Intermediate 315
Intensive 848

Who decides which level of tariff is allocated to the woman?

The budget will be the National Tariff relevant to the woman’s circumstances and the stage of the maternity pathway.  The level of payment is determined by the needs of the woman.

Is the budget ‘cashable’ or only virtual?

PMCBs are notional budgets, so will not be cashable.  They will not involve direct payments into a woman’s bank account.  As is the case now, payments will be made to the providers of maternity services, not to the women who use those services. The choices that women make will determine which providers care for them and therefore receive the associated payments.

What happens if more expensive care is required and there isn’t any money left in the budget?

No woman will be denied care because she has a PMCB and requires more expensive care because of unforeseen complications. If a woman using a PMCB develops complications, she will be entitled to the same care as any other woman accessing NHS maternity care.

Her chosen provider will work within the local maternity system and refer her to more specialised care if she needs it. National Tariff prices take into account the differential costs of providing care to women with complications, depending on their clinical needs and the numbers of women that are expected to develop complications during their pregnancy.