Locally determined prices

Details on local variations, local prices and local modifications, including templates to submit information.


In a range of circumstances, the prices that NHS commissioners pay providers for healthcare services can be determined locally rather than nationally. The national tariff includes a range of flexibilities that can be used to move away from national prices.

This page details the submissions that providers and commissioners of NHS-funded services must make to comply with the requirements set out in the national tariff. Information does not need be to submitted for services without national currencies.

Before submitting local pricing information, please read:

  • Sections 4 and 8 of the 2021/22 National Tariff Payment System
  • Annex F of the 2021/22 National Tariff Payment System

The local variations and prices template below can be used for both prices and variations. The submitted variations and prices are published below. More details about local variations and local prices, and submissions from previous years, are available in the subsequent sections.

If you have any questions about locally determined prices, please contact pricing@england.nhs.uk

Local variations and prices template

This template should be used to record and submit agreed local variations and local prices.

Submitted local variations and prices

This document presents the information from submitted local variations and prices templates for 2019/20. (The payment arrangements introduced in response to Covid-19 mean that variations for 2020/21 and 2021/22 are not being published.)

Local variations

Local variations must be submitted to us by commissioners. They are to be agreed between providers and commissioners and do not need our approval.

Commissioners should complete and submit the local variations and prices template by 30 June or – for local variations agreed after that date – within 30 days of the variation agreement. Completed templates should be sent to pricing@england.nhs.uk.

When is a local variation required?

  • Any adjustments (up or down) commissioners and providers agree to national prices and/or currencies.
  • Local departures from the blended payment for emergency care rules.
  • Contractual agreements, such as changing the emergency care variable element from 20% or to reflect a competitive procurement process that results in a change to currency and/or price.

Please contact pricing@england.nhs.uk if you have questions on whether or not a variation is required.

Local variations, 2015/16 to 2017/19

Local variations submitted for 2015/16, 2016/17 and 2017/19. These were previously published on the pricing portal.

Local prices

Where commissioners and providers use a national currency without a national price as the basis for agreeing local prices, providers should submit details of those prices to us using the local variations and prices template, above.

Where commissioners and providers agree a price without using the national currency, commissioners must instead use the template to submit a local variation.

The list of national currencies without national prices is set out in Annex A of the national tariff.

Information should be submitted to pricing@england.nhs.uk by 30 June or within 30 days of the agreement being reached.

Local prices, 2015/16 to 2017/19

Local prices submitted for 2015/16, 2016/17 and 2017/19. These were previously published on the pricing portal.

Local modifications

Local modifications are intended to ensure that healthcare services can be delivered where they are needed by patients, even if the reasonably efficient cost of providing services is higher than the national price.

All local modifications must be approved by NHS Improvement, who must be satisfied that it would be uneconomic for a provider to provide a service without a local modification.

For details on local modification agreements and applications, and what evidence to provide in the local modifications template, see Section 8.2 and Annex F of the 2021/22 National Tariff Payment System.

For local modification applications submitted in 2021/22 to be granted and take effect on 1 April 2022, providers should submit their application by 30 September.

Submit completed local modification templates to pricing@england.nhs.uk. Please include a declaration that you are authorised to submit the information for your organisation.

Local modifications template.