What we spend and how we spend it

In this section, you can find financial information relating to projected and actual income and expenditure, procurement, contracts and financial audits. 

Our integrated plan has been developed to incorporate many priorities and aligns with the Health and Wellbeing strategies for both Cornwall and the Isles of Scilly. 

Annual budget (financial planning)

Find out more about NHS Kernow's annual budget.

Better payment practice code

The Better Payments Practice Code requires that all valid invoices should be paid by their due date or within 30 days of receipt, whichever is later. Our performance can be followed in our board papers. We are measured in terms of both the number and value of invoices received, against an NHS target to pay over 95 per cent of trade creditors in accordance with the Code.

Board member and director's expenses

Information on board member and director's expenses can be found in our annual report

Budgets and variance reports 

You can read about our budgets in our annual operating plan. High level update reports (variance reports) are included in board papers in the finance area of the performance report.

Capital programme

You can read about this in our annual operating plan.


A list of contracts awarded and their value is available to view here (PDF, 1.29MB). This list will be updated on an annual basis.

You can search for all of NHS Kernow's contracts that are currently being tendered on the Contracts Finder website.

Financial audit reports

You can read the Audit committee updates which summarise key issues and findings in board papers. If you would like more detailed information, you can request this through the Freedom of Information Act. Make an FOI request here


General government funding levels are reported in the annual operating plan and are updated in monthly finance reports which be found in our board papers.

Marginal rate emergency tariff

The 2018/19 National Tariff Payment System Guidance, published jointly by NHS England and Monitor, includes nationally mandated provisions for variation to the tariff payment mechanism to support prevention of avoidable hospital stays. These are: 

  • The marginal rate emergency rule; and
  • Reimbursement arrangements for emergency readmissions within 30 days. 

The marginal rate emergency rule was introduced in 2010/11 in response to a growth in emergency admissions in England which exceeded that which could be explained by population growth and A&E attendance growth alone. This growth in emergency admissions was made up primarily of emergency spells lasting less than 48 hours. The purpose of the marginal rate rule is twofold. It is intended: 

  1. Firstly, to incentivise lower rates of emergency admissions; and
  2. Secondly, to stimulate acute providers to work with other parties in the local health economy to reduce the demand for emergency care. 

The marginal rate rule sets a baseline value (specified in £s) for emergency admissions at a provider. A provider is then paid 70 per cent of the national price for any increases in the value of emergency admissions above this baseline. Overall, commissioners must set aside sufficient budget to pay for 100 per cent of emergency admissions. Commissioners are then required to spend the retained 30 per cent on managing the demand for emergency care. 

The 30 day readmission rule was introduced in 2011/12 in response to a significant increase in the number of emergency readmissions over the previous decade. The rule provides an incentive for hospitals to reduce avoidable unplanned emergency readmissions within 30 days of discharge. Hospitals may reduce the number of avoidable emergency readmissions by investing in, for example, better discharge planning, more collaborative working and better coordination of clinical intervention with community and social care providers. 

This report details the CCG’s circa £9M investment in 2018/19 of the emergency marginal rate retained and readmissions reimbursements set out by pathway and provider to aid transparency.

Prime financial documents

Prime financial documents are available in our annual report.

Staff pay and grading structure

Staff are paid according to the Agenda for Change pay system.

Procurements and tendering processes

Information on our processes can be found here

Transparency - publication of spend over £25,000

In line with the Government's commitment to greater transparency, NHS Kernow is required to publish details of all expenditure over £25,000 on a monthly basis. View our transparency in public expenditure reports