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Excess treatment costs: Payment thresholds lowered for NHS trusts

Date: 15 June 2022

NHS trusts delivering non-commercial clinical research will benefit from additional funding to deliver studies across England – following a financial policy change lowering the point at which trusts can claim back research excess treatment costs.

Excess treatment costs (ETC) are the costs incurred by NHS trusts and care providers involved in delivering research, when the treatments given as part of delivering studies are more expensive than the care/treatment that the participants would have normally received.

NHS England and NHS Improvement’s national NHS Clinical Commissioning Group (CCG) ETC payment system, which is managed by the National Institute for Health and Care Research (NIHR), applies a contribution threshold to NHS secondary care sites for claiming back the excess treatment costs they incur while delivering studies. NHS sites are required to surpass this threshold before any ETC payments can be made.

Impact on ICS/ICBs on CCG ETC Payments

In relation to CCG ETC payments, the NIHR CRNCC is working closely with NHS England to ensure a smooth transition from Clinical Commissioning Groups to Integrated Care Systems/Boards.It is expected that the implementation of the ICS/ICBs will not impact the current national payment service throughout the 2022/23 financial year. Please contact the ETC Helpdesk via if you have any questions.

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