NHS England considers substantive return to ‘payment by results’

NHS England is considering a substantive shift to a ‘payment by results’ model from April, in a bid to drive up elective activity.

Under rules for this financial year, elective care is paid for through block contracts, with additional payments for areas that treat more patients, and supposed penalties for those that fall short.

One well-placed source told HSJ there was “strong momentum” towards reviving PbR for elective care, which could mean trusts being paid purely for each unit of activity delivered, without a block contract element.

There is a belief this could help drive up activity levels, which have remained below the levels recorded before the  pandemic.

Returning to PbR would be a controversial move, as many believe it drives competitive behaviour between providers and goes against the grain of collaboration within health systems.

Other options for changes to the payment system being considered include increasing the rate of incentives and penalties.

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Source: HSJ, 4 November 2022