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Call for integrated care tariff

Sir John Oldham has called for a new tariff that would cover integrated care pathways.

Sir John Oldham has called for a new tariff that would cover integrated care pathways.

Speaking at the recent NAPC annual conference, Sir John said: ‘The tariff has got some perverse incentives and needs reform. I think one of those reforms should be consideration of a tariff that looks at integrated care pathways across [primary and secondary care] organisations.'

Sir John, head of Quest4Quality and member of the National Quality Board, told the Birmingham conference: ‘Too often the tariff has put foremost the needs of the organisations rather than the needs of patients.'

Later he warned the NHS was heading for a ‘tsunami of need': ‘Over the next few decades we are going to see a 252% rise in the number of people over 65. A 180% rise in diabetes. It's a tsunami of need.'

Looking at variation in prescribing, admissions and management of long-term conditions was the answer, Sir John said.

According to Matthew Swindells, the managing director of health group Tribal, 30-40% of patients in acute hospital beds should not be there. Mr Swindells, who was previously a senior policy adviser at the Department of Health, said: ‘These patients are either waiting to die or there isn't a suitable [alternative] place for them.' Mr Swindells said there were also problems with hospital discharge.

He said the number of practices wanting to take on a hard budget would be ‘very small' and the answer to the financial challenge ahead lay in better demand management.

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