Education and training tariff guidance and prices for 2021 to 2022 financial year


1. Purpose of the guidance

1.1 This guidance document is intended to provide further information in support of the education and training (ET) tariff payment process for the 2021 to 2022 financial year, including:

  • an overview of the introduction of the ET tariff payment mechanism for secondary care training placements

  • confirmation of Health Education England’s (HEE) additional responsibilities for ET tariff development from April 2021

  • powers and requirements with regards to the application of the ET tariffs in 2021 to 2022

  • confirmation of the changes to the ET tariffs that are being introduced from 1 April 2021

  • confirmation of the early planning and proposed work programme to inform the ET tariffs for implementation from 1 April 2022

  • further information relating to the ET tariffs for 2021 to 2022, including prices and scope

  • links to further guidance which support and supplement the information contained in this tariff guidance document

  • contact details for any further queries relating to the content of this guidance document

2. Overview and background

2.1 Department of Health and Social Care (DHSC), previously known as the Department of Health (DH), introduced tariffs for clinical placements and undergraduate medical placements in secondary care from 1 April 2013. A similar placement tariff for postgraduate medical trainees came into effect on 1 April 2014. 

2.2 Prior to the introduction of the placement tariffs, payments for training placements were subject to local arrangements, creating inequities in funding. The placements tariffs aim to ensure that providers are reimbursed consistently for the training placements they provide, that placements are high quality and ensure that learners develop the required skills and knowledge to meet their respective professional competencies.

2.3 HEE is responsible for administering the tariff payments to placement providers in line with this tariff guidance document which has been published annually by DHSC on the government website. Alongside HEE’s existing role in administering tariff payments to placement providers, from April 2021 HEE has assumed responsibility for tariff development, including production and publication of this tariff guidance document.

2.4 As part of these new responsibilities, HEE are required to present tariff proposals annually to DHSC for sign-off and ministerial approval. This new approach to developing the placement tariffs does not impact on the existing powers and requirements for the tariffs set out in legislation (see paragraph 2.6 for further information) but does mean this guidance document will now be published on the funding section of the HEE website.

2.5 HEE is currently undertaking a review of the existing governance structures that underpin the tariff setting process and will develop an annual work programme and supporting engagement process to ensure that changes and supporting guidance are communicated to stakeholders to support financial planning for 2022 to 2023. Further information on the early planning underway in preparation for potential implementation from April 2022 is available at paragraph 2.9 of this guidance document.

2.6 Powers and requirements with regards to tariffs for Education and Training (ET) placements were set out in legislation, in the Care Act 2014. These powers came into force in April 2015 and are as follows:

  • the Secretary of State may specify a tariff setting out approved prices, which may be different for different types of ET

  • a tariff specified in this way must be published

  • the Secretary of State may specify a tariff setting out approved prices, which may be revised or revoked by the Secretary of State

  • a published tariff or variation procedure may be revised or revoked by the Secretary of State

  • payments made by HEE or one of its local offices must be made with reference to the approved price, or price as varied under the approved procedure

2.7 The Secretary of State is publishing the approved prices and the procedure for their variation by publishing the tariff guidance. In line with the agreed procedure, HEE will be responsible for publishing details of any price variation

Summary of changes for 2021 to 2022

2.8 In response to feedback from stakeholders around the importance of stability for 2021 to 2022, there are a very limited number of changes to the tariffs for 2021 to 2022. A summary of the changes is included below, along with links and signposts to additional information and guidance. For ease of reference the changes for 2021 to 2022 have been broken into two groups as follows

1. Changes impacting on payments are:

  • the next phase of the changes to the market forces factor (MFF) payment indices will impact on the level of funding that individual providers will receive from the ET tariffs. Further information relating to the application of MFF and the changes to the payment indices from April 2021 can be found on the NHS Improvement website

  • the amounts payable from HEE for postgraduate salaries have been uplifted for 2021 to 2022 to reflect the outcomes of the most recent Spending Review. Confirmation of the HEE contribution to salaries are set out in detail at Annex A of this guidance document

  • HEE has undertaken work to ensure consistency in the calculation of payments for all clinical (previously non-medical) activity. This responds to feedback around the inconsistent interpretation and calculation of what constitutes a full-time equivalent placement. To ensure that this revised approach to calculating payments remains cost neutral at a system level, we have increased the clinical tariff price per full-time equivalent (FTE) by £128

  • confirmation that tariff funding can be paid to providers of eligible simulation-based placement activity. The restrictions on the amount of activity that can be funded are reflective of regulatory expectations

2. Structural changes to the guidance, and additional information aimed at improving the transparency and understanding of the payments.

  • the re-ordering of the guidance to bring together profession specific information into three dedicated sections (clinical, undergraduate medical and postgraduate medical)

  • guidance on funding arrangements for the placement of Doctors in Training in the Independent Sector. This is intended as an introduction and includes a link to the specific guidance published on the HEE website

  • further information and links to the wider funding reforms work currently underway within HEE

2022 to 2023 tariff development

2.9 As part of HEE’s new responsibilities for tariff development, we are already working with stakeholders to finalise the tariff work programme for 2022 to 2023. The work programme will identify priority work areas, including expansion to scope and the resolution of current issues, with the aim of addressing these in time for implementation from April 2022.

2.10 Whilst the tariff work programme is not yet finalised, HEE is already committed to a fundamental review of the current funding and coverage of medical undergraduate placements and the extension of tariff arrangements to include undergraduate dental activity from April 2022.

2.11 The timetable for development of proposals for 2022 to 2023 tariffs will align with the NHS England and NHS Improvement (NHSEI) financial planning timetable and will include earlier and wider engagement on any changes to tariffs than in previous years. Exact details on the engagement process will be communicated in Summer 2021. 

2.12 Further information on the progress of the tariff development work will be shared by HEE as appropriate via the HEE website and regional contacts.

Eligibility for tariff funding

2.13 The placement tariffs are applicable to all placement activity that…



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