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‘Payment by Results’ reform launched


13 May 2013

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NHS England and health sector regulator Monitor are working together to reform the way NHS services are paid for.

NHS England and health sector regulator Monitor are working together to reform the way NHS services are paid for.

Hospitals are currently paid through the Payment by Results system, which has been in operation for nearly a decade and has delivered benefits. 
However feedback from the health sector is that the current system is not sufficiently patient focused, not always based on good quality information, and can act as a barrier to delivering integrated care.
While NHS medical services are free at the point of use for the patient, the system is taxpayer funded. The organizations believe it must deliver better health care for the foreseeable future within the level of funding available.
“We believe the way NHS services are paid for can help deliver the best possible care for patients, for example by encouraging more integrated care, as well as helping the NHS deliver better value for the taxpayer,” said Adrian Masters, managing director of Sector Development at Monitor. 
He added: "This is an opportunity for us to make a real difference to NHS services and we want to work with the sector to achieve this."
Emergency admissions
The organisations believe transfer of responsibility for the design and oversight of the NHS payment system to Monitor and NHS England offers “a good opportunity to look at how the system works today and how it can develop in the future.”
NHS England and Monitor are publishing a joint discussion paper asking for views on the future of the payment system, and a call for evidence on the way hospitals are reimbursed for some emergency admissions. 
The discussion paper also sets out possible improvement and presents early thinking on setting objectives and designing the NHS payment system.
Paul Baumann, NHS England ‘s chief financial officer 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."
There will be minimal change to the 2014/15 National Tariff in order to provide continuity and help providers with their planning. However in the long term Monitor and NHS England are looking at more widespread changes from 2015/16 onwards.
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