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Marginal Rate Credit

The marginal rate rule operates as a national variation to national prices the details of which are set out in section 6.3.1 of the 2014-15 National Tariff Payment System, which continues to have effect until the next national tariff is published.

Under the rule, commissioners are required to publish details of their plans for the investment of retained funds under the marginal rate rule.   Overall, commissioners must set aside sufficient budget to pay for 100% of the cost of emergency admissions and then spend the retained 30%  on schemes to support the management of demand for emergency care.

NHS South Norfolk CCG MRC investments for 2015/16 from Norfolk and Norwich University Hospitals NHS Foundation Trust are as follows:



Home Based Therapy 270
Tracheostomy Service 58
Minor injury LES 217
Intermediate Care 893
Integrated Care Co-ordinators 24
Primary Care admission avoidance schemes (over 75s) 541
COPD 126
SOS Bus 34
Frail and Elderly Persons admission avoidance 174
Total Investment 2,337
MRC value agreed in 15/16 contract 2,334
Additional investment above MRC 3


NHS South Norfolk CCG MRC investments from West Suffolk NHS Foundation Trust are as follows:



Minor Injuries LES 29
Over 75s Spend Breckland Alliance 48
Thetford Home Oxygen Assessment 34
Extended Hours DES 53
Supported Care 164
Pulmonary Rehab 29
Cardiac Rehab 9
Epilepsy Nursing 5
NCH&C Early Intervention Team 15
Care at Home Team 68
St Nicholas Hospice - Palliative Care 78
Intermediate Care Beds 127
Total Reinvestment 660