Categories: Issue archive
      Date: Jul 17, 2006
     Title: Payment by results, in brief

The new system of payment by results....

will reward those treating more patients with extra funding. Foundation trusts will be the first to be funded in this way. One route to financial success for providers will be to choose the treatments or patients that give the greatest return. Complex cases or patients with chronic conditions may lose out, considered too costly or risky. We should be watchful for discrimination or attempts to put financial success before local health needs. There is already evidence that new foundation trusts have asked the Regulator if they can cease or reduce services in the areas where costs are high and income low.

Questions to ask

1. What plans are there to ensure that local NHS staff are not lost to the privately run treatment centres, or to foundation trusts?
2. What does your trust spend on administration, legal fees, and consultancy? Is it increasing? How does it compare with what went before?
3. What services does your local trust supply at a greater cost than the price that they can charge under the new national tariff? Will continuing to supply these services put the trust in deficit?
4. Are there plans to cut services where the return is small or does not exceed costs?
5. What is being done locally to ensure that private providers are inspected and their standards are high?
6. Will your local non-foundation hospitals get comparable additional funding to help to improve their standards?