The Government is to introduce pathway tariffs for conditions such as COPD and diabetes within the next six months.
The move is part of a bigger overhaul of the current payment system revealed in the revised NHS operating framework, published today.
The new payment system is set to reward excellent performance and be tough on poor quality with a focus on outcomes.
New tariff guidance will be published later this year in which a number of pathway – or year of care – tariffs will be introduced. It adds a number of ‘commissioning packs’ are in production, to support the pathway tariffs starting with cardiac rehabilitation which will be published shortly.
Other commissioning packs to be published later this year ‘could include dementia, diabetes, COPD, end of life care and stroke rehabilitation.’
Other changes to the tariff will include moves to make it cover re-ablement and post discharge support, including social care and will encourage the use of community services, home adaptations and extra care housing.
A further change of direction is also in store for transforming community services.
The new Government insists PCTs should still divest of their directly-provided community services by April 2011 but adds one option is to transfer services to other organisations ‘while sustainable medium-term arrangements are identified and secured.’
The framework reveals a long term plan is for community services to be provided under the ‘any willing provider’ model, a system that practice-based commissioners are already familiar with.
The framework says this would facilitate greater participation by the independent and voluntary sector.
On data, the framework says PCTs must put a greater emphasis on using SUS as their data source.
Primary care access targets have been abolished, as has the 18-week referral to treat target as this will no longer be performance managed and the four hour A&E target threshold has been reduced from 98 to 95 per cent.
The Government also wants to see a 46 per cent reduction in management costs by 2013/14.
Health secretary, Andrew Lansley, said: ‘I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes.’