Payment by Results “poses severe challenges”
Government reforms that will bring a market economy into contracts for
hospital work were criticised by the Audit Commission this week.
Payment by Results
· Hospitals are paid for the work they do at nationally
agreed prices under Payment by Results
· Under the old system hospitals are paid according to block contracts
negotiated locally and not linked to actual work carried out
· The system is expected to encourage PCTs to commission more services
in primary care
|
The new
contract system Payment by Results (see Panel right), first introduced
in foundation hospital trusts in April 2004, “poses
severe challenges for financial management in some trusts and health
economies”,
said its report “Early
lessons from Payment by Results”.
The commission fell short on recommending that plans to extend the system
to all NHS trusts next April should be abandoned. But it did warn ministers
that the “potential benefits” of the system would only be
realised once clinicians understood its implications and there is “significant
improvement” to NHS contracting information and financial systems.
Audit Commission chairman James Strachan said: “It is clear that
foundation trusts and PCTs have been challenged by the complexities of
introducing Payment by Results and it has exposed underlying financial
difficulties where they exist. There are real dangers for the NHS in
the short term, particularly given the recent increase in the number
of organisations and areas with financial problems.”
In a statement Health Secretary Patricia Hewitt said the Government was
pushing ahead with its plans to roll out Payment by Results by next April.
She said: “Payment by Results is not causing financial problems
in the NHS. It is revealing problems in some NHS trusts and helping them
to overcome their difficulties. Payment by Results is part of the solution
not the problem.” |
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