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Performance pay for NHS hospitals Performance pay for NHS hospitals
(about 4 hours later)
Hospitals are to have pay linked to performance by using patient experience to measure the quality of care.Hospitals are to have pay linked to performance by using patient experience to measure the quality of care.
Gordon Brown, in his draft version of the Queen's Speech, said it was part of making the NHS more "patient-centred".Gordon Brown, in his draft version of the Queen's Speech, said it was part of making the NHS more "patient-centred".
It is likely to mean a tweak to the payment by results funding system under which hospitals in England are paid a set price for each treatment.It is likely to mean a tweak to the payment by results funding system under which hospitals in England are paid a set price for each treatment.
But experts remained sceptical over how performance could be incorporated into an "already complicated" system.But experts remained sceptical over how performance could be incorporated into an "already complicated" system.
The government is not setting out the full details of the changes.The government is not setting out the full details of the changes.
But Mr Brown said: "For the first-time payments to NHS hospitals will be adjusted according to patient satisfaction and health outcomes."But Mr Brown said: "For the first-time payments to NHS hospitals will be adjusted according to patient satisfaction and health outcomes."
As expected, he also said there would be an NHS Reform Bill which will pave the way for an NHS constitution setting out what patients can expect in terms of access, safety and quality.As expected, he also said there would be an NHS Reform Bill which will pave the way for an NHS constitution setting out what patients can expect in terms of access, safety and quality.
And the prime minister confirmed personal budgets will be introduced to give people with long-term conditions, such as diabetes, more control over their care.And the prime minister confirmed personal budgets will be introduced to give people with long-term conditions, such as diabetes, more control over their care.
The concept is right, but what we do not need is for the changes to be rushed Jonathan Fielden, of the British Medical AssociationThe concept is right, but what we do not need is for the changes to be rushed Jonathan Fielden, of the British Medical Association
Payment by results has been rolled out across most hospital services in recent years.Payment by results has been rolled out across most hospital services in recent years.
It means NHS trusts are paid for each patient they treat rather than getting a lump sum as happened in the past.It means NHS trusts are paid for each patient they treat rather than getting a lump sum as happened in the past.
It was designed to reward the best hospitals, but the system has not been easy to introduce with many complaining it did not reflect the complexity of treating people.It was designed to reward the best hospitals, but the system has not been easy to introduce with many complaining it did not reflect the complexity of treating people.
A recent report by the Audit Commission said it had not led to the improvements in efficiency that had been envisaged.A recent report by the Audit Commission said it had not led to the improvements in efficiency that had been envisaged.
And problems with the thousands of different individual tariffs have led to health chiefs having to constantly update them.And problems with the thousands of different individual tariffs have led to health chiefs having to constantly update them.
Complicated systemComplicated system
Professor John Appleby, chief economist at the King's Fund health think-tank, said he was sceptical over the merits of changing an "already complicated" system.Professor John Appleby, chief economist at the King's Fund health think-tank, said he was sceptical over the merits of changing an "already complicated" system.
He said it would make more sense to get primary care trusts, which are responsible for buying services off hospitals, to use data already available to commission from the best-performers.He said it would make more sense to get primary care trusts, which are responsible for buying services off hospitals, to use data already available to commission from the best-performers.
And he added: "You will end up putting primary care trusts in a situation where they have a choice of paying to give fewer patients top quality care or more patients average care. It puts them in a difficult position."And he added: "You will end up putting primary care trusts in a situation where they have a choice of paying to give fewer patients top quality care or more patients average care. It puts them in a difficult position."
Jonathan Fielden, chairman of the British Medical Association's consultants committee, said: "The concept is right, but what we do not need is for the changes to be rushed."Jonathan Fielden, chairman of the British Medical Association's consultants committee, said: "The concept is right, but what we do not need is for the changes to be rushed."
But Steve Barnett, of the NHS Confederation, said: "The NHS needs to focus more on patient experience and health outcomes and a review of the payment system will be a helpful step in realising this."