A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...

Variable monetary penalty: Variable monetary penalties require a provider to pay afinancial penalty of such amount as Monitor may specify. The variable monetary penaltymust not exceed 10% of the provider’s turnover in England.Discretionary requirements may be used in combination in relation to the same breach, whereappropriate. However, Monitor must not impose discretionary requirements on more than oneoccasion in relation to the same breach.3.3 Deciding what kind of discretionary requirements to imposeIn considering what, if any, discretionary requirements to impose, Monitor’s aim is to ensure thatany action we take promotes compliance and fulfils Monitor’s main duty to protect and promotethe interests of people who use health care services, by promoting the provision of health careservices which is economic, efficient and effective, and maintains or improves the quality of theservices. We will ensure also that we take into account all our other duties as appropriate inexercising our enforcement functions.In deciding what action is most appropriate in the circumstances of the individual case and whichrequirements, if any, to impose, we intend to consider, amongst other relevant considerations:the seriousness of the breach;ensuring provider compliance;deterring similar breaches;restoring the position to what it would have been without the breach; andthe proportionality of the remedy to the nature of the breach.Monitor may decide not to impose a discretionary requirement if we conclude that:the breach caused (or was capable of causing) no harm or harm that is not material;a discretionary requirement is not required to ensure provider compliance;a discretionary requirement is not required to restore the position to what it would havebeen without the breach; anda discretionary requirement is not required to deter similar breaches.Monitor may also decide not to impose a discretionary requirement if we conclude that the onlysuitable discretionary requirement would be disproportionate to the nature of the breach.Page 18 of 50