Review pay system for health care providers

It is time to review the system used to pay health care providers, a new report has argued as part of its eight principles for a future payment system.

Towards an effective NHS Payment system, jointly produced by NHS Providers and the Health Foundation, says that clarity of purpose is required to refocus the system’s many objectives.

Having extensively engaged with NHS trust workers on how the current payment system impacts on those providing care, the report has identified eight guiding principles that a payment system should meet to support providers in delivering high quality care: clear purpose; realistic expectations about impact; national consistency with local flexibility; appropriate, aligned incentives; high quality data; balance between complexity of design and ease of use; independent oversight and support; and time to embed and evaluate systems.

Phillippa Hentsch, head of analysis at NHS Providers, said: "For too long, the payment system has been used as a way to close the financial gap facing the sector, forcing prices down while provider costs continue to increase. Although there will continue to be diverse views on what a future system should look like, providers argue that the national level needs to go back to basics, simplifying and clarifying the ask of the sector. We hope these principles help support the system to review and move towards an effective model, based on high quality data and with the time and space to bed in consistently across the sector."

Adam Roberts, head of Economics at the Health Foundation, added: "This in-depth engagement has given us an invaluable insight into how the payment system is working for those who are delivering care to patients. In its entirety the system lacks a clear purpose, and so is trying to achieve too many things. The NHS is currently looking to change the way it provides services across the country, following the Five year forward view. The time is right to consider how the payment system can best support this, by identifying what works well and what needs to change. There is no one-size-fits-all system for the NHS, but the principles presented in this report act as a guide to what would best support providers in improving care services in future."