The NHS is to moderate its underpayment of hospitals for seeing patients in A&E, the Guardian website reports. A big headache for NHS hospitals has been that theyt have not been getting full fees for patients attending A&E. Instead they get only 30% of the fee for every patient more than seen in the year 2008/9. With steeply rising attendance this has put finances under strain. CCGs have been advised to spend the money withheld with providers. Locally some of the money withheld from the RBH has returned to it but by no means all the money withheld. It is now reported that Monitor, the organisation which is charged with supervising providers and setting the treatment tariffs, has decided that CCGs and providers will have to agree their own threshold for withholding part of the fee, and will have to show that money withheld is being spent on alternatives to A&E. Although CCGs are getting a little more money (in real terms) this year than last, some is being transferred to a pooled budget with Social Care, so this wil put local budgets under further strain. South Reading NHS CCG has indicated that it will work to keep more patients in their own homes rather than in hospital, where appropriate, with its projected "Hospital at Home" programme, of which we expect to hear more in the coming months.