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NHS England to review hospital incentives

NHS England has proposed to ditch the ‘payment by results’ method used to pay hospitals in a major shake-up of healthcare funding.

Monitor and NHS England are to look into the funding method of healthcare service, claiming that PbR is ‘not sufficiently patient focused’ and can act as a ‘barrier to integrated care’.

Any changes will be introduced from 2015/16 and will be designed in part to promote preventative care.

A discussion paper, produced by Monitor and NHS England, said: ‘A prominent concern is that, in the main, PbR still pays for activities, not patient outcomes. These may match closely in some cases, but not all. Good patient outcomes may result from many different types of care, including one-off interventions, discrete episodes, or continuous case management. But there are few types of care in which paying for activities is sufficient to encourage the best patient outcomes.’

Paul Baumann, chief financial officer at NHS England said: ‘We are keen to use this opportunity to develop and design a new payment system that does more for patients. We are asking people to contribute by answering the four questions set out in the document.

‘Changes to this system will not happen overnight, and it is important we get this right. As part of this engagement we are gathering evidence to support short and longer term improvements to the payment system.’

Readers' comments (2)

  • Oh Dear, back to block contracts! An expensive experiment gone wrong

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  • Until PbR commssioners had very little idea what they were spending their money on: it all went into one big pot. Each year marginal changes in the budget were discussed in minute detail but not the content, purpose or cost of the budget as a whole. All providers had to be branches of the same colossal structure - run as smoothly, efficiently and with as much local sensitivity as one would expect from an organisation with the size and command structure of the Red Army. PbR provides the analysis, language and currency for the NHS to function as a system, not a hierarchy.

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