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Maternity incentive scheme appeals process

Background

The Appeals Advisory Committee (AAC) has been established by NHS Resolution to receive and consider appeals from provider trusts, and make recommendations to NHS Resolution’s Chief Executive as to whether those appeals fall within the specified grounds for appeal (referenced below).

NHS Resolution’s Chief Executive remains the final arbiter of any appeal decisions.

Grounds of appeal

The remit of the AAC is to consider any valid appeal received from participating trusts.

An appeal will be valid if it falls within one or both of the following two possible grounds for appeal:

  1. failure by NHS Resolution to comply with the published ‘conditions of scheme’ and/or guidance documentation
  2. technical errors outside the trusts’ control and/or caused by NHS Resolution’s systems

Appeals on any other grounds will not be considered. This includes any appeal relating to a financial decision made, for example a discretionary payment made against a submitted and valid action plan, and in accordance with the published conditions of the scheme will not be considered.

Requirements and appeal procedure

Using the online appeals template the appeal must be signed by the trust’s Chief Executive and sent to NHS Resolution (MIS@resolution.nhs.uk) between Wednesday 9 October and 12pm on Thursday 17 October 2019.

NHS Resolution Early Notification clinical team will review all appeals to ensure their validity, i.e. to determine if these fall into either, or both, of the two specified grounds for appeal. If an appeal does not fall within the specified grounds for appeal, it will be rejected and NHS Resolution will correspond with the trust directly with no recourse to the AAC.

If the NHS Resolution Early Notification clinical team consider that the appeal falls within one or both of the specified grounds for appeal it will be referred for consideration by the AAC.

The referral to the ACC will include the appeal correspondence and any relevant supporting evidence submitted by the trust. It will be a matter for the trust to provide evidence in support of its appeal. NHS Resolution may also review its own records.

Following either a unanimous or majority decision the ACC will recommend whether the appeal should be upheld and reported to NHS Resolution’s Chief Executive for final determination.

Timescales

Appeals window opens: Wednesday 9 October 2019

Appeals window closes: Thursday 17 October 2019 (12pm)

Appeals decisions communicated: Friday 15 November 2019

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