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Calls for new incentives for chronic disease management

The Government must investigate new systems of incentives for the management of long-term conditions, a new report from three leading medical colleges concludes.

It urges the Department of Health to explore the idea of payment by pathway for an episode of care and annual payments by condition for long-term conditions.

The report, developed by a joint working party of the Royal College of Physicians, the Royal College of General Practitioners and the Royal College of Paediatrics and Child Health, also warns of ‘perverse incentives' within Payment by Results, which has been criticised for rewarding volume, rather than quality, of care.

Entitled Teams without walls - the value of medical innovation and leadership, the report says the most effective way to achieve the Government's aim of care closer to home is to have jointly commissioned integrated health services provided by primary and secondary care.

Professor Steve Field, chair of the RCGP, said: ‘Developing closer working relationships between primary and secondary care clinicians will enable us to set up smoother care pathways and provide a wider range of integrated health services.

‘This is particularly important for patients who move frequently between primary and secondary care, such as those with long-term conditions and the elderly.'

A Department of Health spokesperson confirmed it was looking at the proposals closely. ‘The suggestions of paying for pathways and annual payments for Long Term Conditions were both raised in last year's Payment by Results consultation and are being pursued, for example for mental health and for diabetes.

The report, also endorsed by the NHS Alliance, can be found on the RCP and RCGP websites.

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