Guidance for LCRNs on ETC Payment Models

Clinical Commissioning Groups (CCGs) ceased to exist and were replaced by Integrated Care Boards (ICBs) on 01 July 2022. This site has been updated to reference ICBs.

From April 2020 ICB Excess Treatment Cost (ETC) payments can be paid to organisations incurring ETCs rather than the previous payment model where payments could only be made to the recruiting sites. In order to determine the correct route for payment, a decision tree is used that allows the Sponsor and Chief Investigator (CI) the flexibility of selecting one of eight ICB ETC payment models that best fits their study.

The steps are as follows:

1) Once the Sponsor/CI liaises with the Lead LCRN to finalise the SoECAT and submits to CRNCC Triage, the CRNCC Triage team assigns a commissioner and informs the CRNCC Finance team of the outcome.

2) For ICB studies with ETCs greater than a zero value, the CRNCC Finance team contacts the Sponsor/CI to go through the decision tree and select one of the eight payment models that best fits their study. The Lead LCRN is copied into the emails.

3) When the payment model has been selected, the ETC Helpdesk emails the Sponsor, CI and Lead LCRN to confirm the payment model that has been agreed and ask for further site information and payment ratios needed for that payment model. The email includes an illustration table for the payment model that has been selected, to show that the final numbers will work as per the SoECAT.

4) ICB ETC payments are made every second financial quarter based on the recruitment recorded and confirmed on CPMS by the NIHR quarterly data cut deadlines. Where applicable, payments are subject to any relevant Provider Thresholds set by NHS England or the Minimum Payment Trigger applicable to primary care providers.

When working with the Sponsors/CIs during the completion of the SoECAT, LCRNs are asked to inform them that, for any ICB-commissioned study with ETCs, the CRNCC Finance team will contact them via the ETC Helpdesk to select the ETC payment model for their study.

LCRNs are not expected to understand or discuss the decision tree with Sponsors/CIs. This responsibility lies with the CRNCC Finance team only.

For any further detail on the payment mechanism please refer to the ICB ETC payment principles which are available on the Operational page of this site.