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Showing results for tags 'Financial Incentives'.
Found 28 results
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News Article
Trusts penalised for exaggerating safety standards
Patient Safety Learning posted a news article in News
Dozens of trusts have been hit with financial penalties after regulators questioned their claims to be compliant with maternity safety standards. The maternity incentive scheme, run by NHS Resolution, gives trusts “refunds” on their payments to its clinical negligence scheme if they meet 10 safety-related criteria, which trust boards must declare against each year. The 10 requirements include appropriate staffing, reviewing deaths using a national tool, and board oversight of maternity services. However, NHS Resolution can investigate if concerns are raised — for example in a Care Quality Commission inspection — and these conflict with the trust’s submission. The payments to trusts can then be withdrawn, or withheld if they have not already been paid. HSJ analysis of data shared by NHS Resolution found 24 trusts had to make one or more repayments in the first four years of the scheme, which started in 2018 and was relaunched after the pandemic. Read full story (paywalled) Source: HSJ, 17 June 2025 -
News Article
ICBs told to get tighter grip on GP referrals
Patient Safety Learning posted a news article in News
Integrated care boards have been told to significantly strengthen the drive to ensure that potential GP referrals are first scrutinised by hospital consultants. The approach, known as “advice and guidance”, involves GPs discussing cases with specialist consultants. The discussions can lead to the patient being triaged to alternative services or the GP continuing to be responsible for their management, rather than being placed on a waiting list to see a consultant. The use of A&G to reduce referrals is a key plank of NHS England’s plan to deal with the elective care backlog. NHSE’s elective reform plan pledged to drive up A&G requests by GPs to 4 million in 2025-26, nearly double the amount seen in 2023-24. NHSE forecasts this would deliver 2 million “diversions” – cases where a referral is avoided. For the first time, GPs will be paid £20 each time they use the model, and the government has announced that an £80m pot has been allocated to fund the policy. But new guidance published by NHS England warns local systems must deliver a “higher degree of rigour and standardisation” in their A&G services. It also sounds the alarm about the “considerable variation” in A&G models operating in different areas. Read full story (paywalled) Source: HSJ, 17 April 2025 -
Content ArticleThe government priority is to return to the 18-week referral to treatment (RTT) standard through reforming elective care by March 2029. In support of this, NHS England has published a plan for reforming elective care for patients, setting out 4 key priority areas. Care in the right place is one of the 4 areas, which includes Advice and Guidance (A&G) services and clinical triage of referrals. Advice and Guidance aims to ensure patients receive optimal care, as quickly as possible, in the most appropriate care setting while upholding patients’ rights to choice. The Enhanced Service Specification sets out the requirements for payment of pre- referral Advice and Guidance requests. There is considerable variation in how Advice and Guidance is applied, delivered and monitored. It is important to manage patient demand, so a higher degree of rigour and standardisation is needed. This framework has been created as a tool to support ICBs to ensure Advice and Guidance is implemented effectively. This approach will enable them to embed Advice and Guidance in their leadership, culture, operational processes and build on existing good practice in line with NHS IMPACT. The framework has been co-produced, including input from a focus group of NHS colleagues from regions, ICBs, primary care and secondary care providers.
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Content ArticleThis article, co-authored by IHI President Emeritus and Senior Fellow Don Berwick, highlights how healthcare in the US is failing patients and presents a vision of a system that better supports the nation’s needs.
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News Article
'There could be no NHS dentists in two years'
Patient Safety Learning posted a news article in News
A dentist says he feels "strangled" by NHS contracts and believes NHS dentists may not exist in two years' time. Dr Harj Singhrao, who has a practice in Newbridge, Caerphilly, said money was allocated on a "one size fits all basis" meaning in high need areas like his, he had to lose money in order to provide good care. It comes as the British Dental Association (BDA) Cymru published an open letter accusing the Welsh government of "peddling half- truths", adding more practices were looking to hand NHS contracts back. The Welsh government said: "We are working to ensure the NHS dental contract is fairer for patients and to the dental profession." Dentists who want to treat NHS patients sign a contract with the Welsh government, which then gives them money per patient under the condition of certain targets, such as seeing a certain number of new patients. If these targets are not met, dentists may have to pay some money back as a penalty. Dr Singhrao is the principal dentist at Newbridge Dental Care and had to pay £50,000 back to the Welsh government. He said this was because he took on too many new NHS patients, but had to close a position at his practice as a result. He said the formula of treating every patient across Wales equally "does not work". Read full story Source: BBC News, 17 February 2025 -
News ArticleThe pharmaceutical watchdog has reprimanded Wegovy maker Novo Nordisk for failing to correctly disclose dozens of payments to the UK health sector as it sought to boost sales of its slimming drugs. The Danish drug giant – Europe’s most valuable listed company – systematically misreported, under-reported or did not disclose funding given over seven years to pharmacy firms, obesity charities, training providers, professional bodies and patient groups. Even after admitting to errors and conducting an internal review, it failed to accurately report its spending. The company has now been formally reprimanded by the Prescription Medicines Code of Practice Authority (PMCPA), which said it had brought the industry into disrepute. Finding 48 breaches of the industry code, it said serious compliance failings – committed while Novo Nordisk was already the subject of an audit after previous breaches – “raised questions about the culture of the company and demonstrated poor governance and a lack of care”. It said that “by failing to publicly disclose payments, inaccurately reporting and misreporting payments to healthcare organisations and patient organisations over an extended period of time”, it “had brought discredit upon, and reduced confidence in, the pharmaceutical industry”. Read full story Source: The Guardian, 26 January 2025
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News Article
GPs to be paid to seek consultant opinion before referring
Patient Safety Learning posted a news article in News
New payments for GPs to incentivise a significant reduction in referrals are among a range of measures being announced by the prime minister in a “radical” new plan to slash the elective waiting list. As well as a major expansion of “advice and guidance”, which involves GPs discussing cases with specialist consultants to try to avoid a referral, the government has claimed new “elective reform plan” will include ramping up activity in community diagnostic centres and “elective hubs”, and ensuring more patients are offered a choice of provider. However, many of the details of how these changes will be achieved have yet to be revealed. Most of the planned improvements also involve initiatives which have been under way for some time, or have been previously announced. The full plan is not set to be released until Monday afternoon. Trusts will be ordered to put “non-clinical frontline staff like receptionists on compulsory ‘customer service’ training [to ensure the NHS delivers] a new gold standard retail offer”, the Department for Health and Social Care said on Saturday. There will also be extensive upgrades to the NHS app, including direct booking of diagnostics, to improve access, choice, and the options available while waiting. Read full story (paywalled) Source: HSJ, 5 January 2025 -
News Article
New leaders bring ‘energy, focus and grit’ to troubled trusts, says NHSE
Patient Safety Learning posted a news article in News
Changing chairs, CEOs and finance chiefs has helped turn around several poorly performing trusts and systems, NHS England has said, but it plans to do more to “strengthen” leadership at troubled organisations. Dame Emily Lawson made the comments in an update to NHSE’s board on its “recovery support programme”, which is the current name of its intervention regime for the most poorly performing trusts and systems. The NHSE chief operating officer said: “We know we have got more to do… to strengthen leaders at the most challenged places. We are developing a more systematic way of identifying and developing talented leaders and matching them to roles where they can make the biggest impact when in post. “That means we need to give leaders the right flexibilities, incentives and support to turn things around.” Read full story (paywalled) Source: HSJ, 6 December 2024 -
Content ArticleThis policy brief from the Institute for Policy Research recommends key legislative reforms to enhance financial transparency in industry-NHS collaborations. The Government faces a key balancing act: growing a world-leading life sciences sector while safeguarding patients from the risks posed by financial conflicts of interest between pharmaceutical and medical device companies and the NHS, its staff and professional bodies. Ensuring full transparency of these ties is essential, but the current disclosure system, created and overseen by the industry, does little to address these risks. Independent research and the Independent Medicines and Medical Devices Safety Review have highlighted its failures. In addition, cases of avoidable patient harm and instances of major companies failing to disclose payments underscore the urgent need for reform. The Government’s proposals in 2023 offered only modest improvements. This policy brief, written by a team of international academic researchers and UK-based patient advocates, recommends legislative changes in three key areas based on patient experience, international best practices and research evidence. The reforms will promote transparency by being comprehensive, enforceable and actionable. In so doing, they will support the Government’s core missions to strengthen the NHS and drive investment in life sciences. Following the scope of the IMMDS Review, the reforms focus on England, but their core transparency principles are relevant for all devolved administrations within the UK.
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Content ArticleAn analysis by The BMJ has found that pharmaceutical companies pay tens of millions of pounds to the NHS each year without the public being told what the payments are for. The findings have led to calls for a shake-up of current transparency rules so that patients can see why payments are being made to the NHS. Pharmaceutical companies paid £156m to NHS trusts in England between 2015 and 2022, according to new analysis of the Disclosure UK database. The Association of the British Pharmaceutical Industry (ABPI) database requires participating companies to disclose cash payments and other benefits in kind to healthcare professionals and organisations. Even though the scheme has been lauded as one of the best among its industry run peers in Europe, The BMJ has uncovered widespread confusion about the intended purpose of the payments. For example, if any of these payments are for “educational” purposes that could be linked to the promotion of pharmaceutical products.
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Content ArticleThis review has concluded that hospitals that are privatised typically deliver worse quality care after converting from public ownership. The researchers carried out a meta-analysis based on evidence from 13 longitudinal studies, covering a range of high-income countries.* Each study assessed quality of healthcare measures for patients before and after health service privatisation, at either the hospital or regional level. The studies included measured indicators of care quality which included staffing levels, patient mix by insurance type, the number of services provided, workload for doctors, and health outcomes for patients such as avoidable hospitalisations. Key findings: Increases in privatisation generally corresponded with worse quality of care, with no studies included in the review finding unequivocally positive effects on health outcomes. Hospitals converting from public to private ownership status tended to make higher profits. This was mainly achieved by reducing staff levels and reducing the proportion of patients with limited health insurance coverage. Privatisation generally corresponded with fewer cleaning staff employed per patient, and higher rates of patient infections. In some studies, higher levels of hospital privatisation corresponded with higher rates of avoidable deaths. However, in some cases (e.g. Croatia), privatisation led to some benefits for patient access, through more precise appointments and new means of care delivery, such as out-of-hours telephone calls.
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EventIn this webinar, Chris Burman-Fourie, principal NHS consultant, and Nick Reader, principal consultant at GoodShape, will explore the correlation between employee health and organisational financial savings. The presenters will share actionable insights, best practices, and real world examples that demonstrate how investing in employee health can yield significant financial returns. Key topics to be covered include: Understanding the tangible impact of employee health on productivity, organisational performance, and healthcare costs. Exploring innovative approaches to fostering a culture of wellbeing and resilience among NHS staff. Leveraging data analytics to measure the impact of employee health programs on financial outcomes and savings. Using employee health data to tailor wellbeing programmes and benefits to give measurable results. Understanding workforce absence and health data to drive down bank and agency usage across NHS Trusts. Register
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Content ArticleHSJ brought together a panel of trust chief executives drawn from its annual list of the NHS’s Top 50 CEOs. Their discussion explored how trusts will cope with the renewed financial challenge and what values-based leadership means to them. Many of the CEOs at the roundtable complained there no longer seemed to be any reward for good financial performance now that the health of system finances trumped those at individual organisations.
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Content ArticleInternationally, there is a growing awareness on diagnostic errors as a major – and too often overlooked – patient safety problem. According to analyses conducted by the Danish Society for Patient Safety, diagnostic errors are not only common, but they also have major consequences for patients and the healthcare system’s finances. In this article, Charlotte Frendved and Siri Tribler hope that by raising awareness of the diagnostic process and possible vulnerabilities can help improve patient safety.
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Content ArticleReport from HSJ, in association with Allocate Software, on why patient safety should be the core business of healthcare.
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News Article
Drug firms funding UK patient groups that lobby for NHS approval of medicines
Patient Safety Learning posted a news article in News
Drug companies are systematically funding grassroots patient groups that lobby the NHS medicines watchdog to approve the rollout of their drugs, the Observer has revealed. An investigation by the Observer has found that of 173 drug appraisals conducted by the National Institute for Health and Care Excellence (NICE) since April 2021, 138 involved patient groups that had a financial link to the maker of the drug being assessed, or have since received funding. Often, the financial interests were not clearly disclosed in NICE transparency documents. Many of the groups that received the payments went on to make impassioned pleas to England’s medicines watchdog calling for treatments to be approved for diseases and illnesses including cancer, heart disease, migraine and diabetes. Others made submissions appealing NICE decisions when medicines were refused for being too expensive. In one case, a small heart failure charity that gave evidence to a NICE committee arguing for a drug to be approved received £200,000 from the pharmaceutical company, according to the maker’s spending records. In another case, a cancer patient group supplied evidence relating to drugs made by 10 companies – from nine of which it had received funding. Read full story Source: The Guardian, 22 July 2023 -
Content ArticleIn a blog for the Healthcare Financial Management Association (HFMA), Patient Safety Learning’s Chief Executive Helen Hughes highlights both the human and financial costs associated with the persistence of avoidable harm in healthcare. She outlines how Finance directors should play a key role in improving patient safety and argues that they have an essential corporate leadership role to ensure healthcare is both effective and safe. Highlighting the scale of avoidable harm in healthcare, this HFMA article notes that: In high-income countries, the World Health Organization estimates that 1 in every 10 patients is harmed while receiving hospital care. This harm can be caused by a range of adverse events, with more than 40% of them being preventable. NHS England estimates, pre-Covid, that there are around 11,000 avoidable deaths annually due to safety concerns. Turning to the financial impact of this, it highlights that: The Organisation for Economic Co-operation and Development estimates that the direct cost of treating patients who have been harmed during their care in high-income countries approaches 13% of health spending. Excluding safety lapses that may not be preventable, this figure is considered to be 8.7% of health expenditure. The cost of settling litigation claims in the NHS in 2021/22 came to £2.5bn, with a further £13.3bn spent on compensation claims settled in previous years. Discussing key role that Finance directors can play in improving patient safety, it identifies four key priorities they should consider: Financial incentives: ensuring that existing measures don’t have unintended negative impacts on safety and the development of mechanisms to incentivise safer care. Board oversight: highlighting the financial implications of avoidable harm in board reports and risk registers; the true costs of unsafe care. Developing and supporting a business case for safety: investing in re-designing systems, processes and ways of working to deliver safer care and reduce the costs of avoidable harm. Championing patient safety: safer organisations are more cost-effective ones.
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Content ArticleThe objective of this analysis, published in the BMJ, was to determine whether the withdrawal of the Quality and Outcomes Framework (QOF) scheme in primary care in Scotland in 2016 had an impact on selected recorded quality of care, compared with England where the scheme continued.
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News Article
Trusts offered up to £4m to make last-ditch attempt on A&E target
Patient Safety Learning posted a news article in News
NHS England has confirmed new financial incentives for trusts to deliver strong performance against the four-hour emergency target this month. National leaders are desperate for the NHS to hit the four-hour target in 76% of cases in March, telling trusts earlier this month that it was necessary to restore confidence in the health service. They took the unusual step at the start of the month of asking local leaders to sign a commitment to deliver the necessary performance. The recent pressure has come under criticism for encouraging hospitals to prioritise four-hour performance over caring for the sickest patients. It was also indicated there would be new financial incentives for those delivering the best performance. In a letter, NHSE confirmed a significant expansion to the criteria for trusts to claim a share of a £150m incentive fund, by improving their headline accident and emergency performance. Read full story (paywalled) Source: HSJ, 12 March 2024 -
Content Article
NHS Confederation: The state of NHS finances 2024/25
Patient Safety Learning posted an article in Data and insight
This report examines the financial challenge facing NHS organisations in 2024/25. Key points The number one challenge facing NHS leaders and their staff is how they balance their books while protecting patient safety given many organisations are having to achieve significant efficiency savings. A comprehensive survey of NHS leaders carried out by the NHS Confederation shows that many NHS organisations are having to meet high efficiency targets of 5% and beyond, with some as high as 11%. This is the tightest financial position NHS organisations have faced in years. More than six in ten (61%) of NHS leaders say they will need top-up funding from the government within the year to have a chance of hitting their efficiency targets. This would mean some end the year in deficit against their plans, much like many did in 2023/24. The NHS Confederation has consistently said that this type of ‘boom and bust’ planning hinders NHS leaders’ ability to plan services and represents poor value for money. The main ways NHS leaders say they will reduce spending is by cutting spending on agency, locums and/or bank staff, as well as freezing vacancies. There is a dissonance between the government’s plans to expand the NHS workforce over the next decade through the NHS Long Term Workforce Plan and what NHS organisations are having to do in the short term, which will result in posts being cut or frozen. Two thirds say that industrial action will continue to contribute to them not being able to meet their targets. We are now almost 18 months into the industrial dispute, with further strikes set for late June. The government needs to find a solution as this has become ‘business as usual’ for the NHS, with implications for reducing waiting lists and staff morale. As well as industrial action, the major barriers to improving productivity continue to be lack of capacity in social care and a lack of capital investment, as well as the likely impact of having to cut non-clinical staff who would otherwise play a key role in helping to reform services. More than six in ten (61 per cent) of NHS leaders said they cannot meet their current targets without further capital investment, while more than eight in ten say there needs to be a funding increase for social care. -
Content ArticleMedical device industry payments to healthcare organisations (HCOs) can create conflicts of interest which can undermine patient care. One way of addressing this concern is by enhancing transparency of industry financial support to HCOs. MedTech Europe, a medical device trade body, operate a system of disclosure of education payments to European HCOs. This study aimed to characterise payments reported in this database and to evaluate the disclosure system. Highlights Between 2017 and 2019, 116 medical device companies disclosed over €425 million in payments. A small number of medical device companies accounted for the vast majority of these payments and most payments were to healthcare organisations in a small number of countries. The database itself was rated as having a range of significant shortcomings such as the limited breadth of recipients, donors, and payment areas covered. A European wide system of mandatory disclosure for the medical device and pharmaceutical industries addressing these areas should be introduced to address the shortcomings of this database.
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Content ArticleConflicts of interest inherent in industry funding can bias medical research methods, outcomes, reporting and clinical applications. This study, published in Europe PMC, explored the extent of funding provided to American physician researchers studying surgical mesh used to treat uterine prolapse or stress urinary incontinence, and whether that funding was declared by researchers or influenced the ethical integrity of resulting publications in peer reviewed journals.Authors conclude that journal editors' guidelines re declaring conflicts of interest are not being followed. Financial involvement of industry in mesh research is extensive, often undeclared, and may shape the quality of, and conclusions drawn, resulting in overstated benefit and overuse of pelvic mesh in clinical practice.
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Content ArticleMedical device industry payments to healthcare organisations (HCOs) can create conflicts of interest which can undermine patient care. One way of addressing this concern is by enhancing transparency of industry financial support to HCOs. MedTech Europe, a medical device trade body, operate a system of disclosure of education payments to European HCOs. This study aimed to characterise payments reported in this database and to evaluate the disclosure system. Highlights Between 2017 and 2019, 116 medical device companies disclosed over €425 million in payments. A small number of medical device companies accounted for the vast majority of these payments and most payments were to healthcare organisations in a small number of countries. The database itself was rated as having a range of significant shortcomings such as the limited breadth of recipients, donors, and payment areas covered. A European wide system of mandatory disclosure for the medical device and pharmaceutical industries addressing these areas should be introduced to address the shortcomings of this database. Related reading: Sling the Mesh's response to the report
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News Article
‘Ludicrous’ expectation pushes trusts to plan savings of up to 9%
Patient Safety Learning posted a news article in News
NHS trusts are signing up to deliver efficiency savings of up to 9% of costs, HSJ has found. The Queen Elizabeth Hospital King’s Lynn has a cost improvement programme of nearly £30m in 2024-25, equivalent to 9% of spending, which is three times higher than the amount it delivered last year. Trusts and commissioners were last month issued with new financial targets as NHS England attempted to bring down a £3bn forecast deficit for local organisations. A spokeswoman told HSJ the trust had already identified three-quarters of the £30m, and said “we believe that there are further efficiencies in our system, which would see us go further than the 3.1% achieved last year.” She added: “All cost-saving initiatives go through a robust process to make sure that they will not impact patient safety or clinical care provided by the trust.” Read full story (paywalled) Source: HSJ, 1 July 2024 -
News Article
Medical device companies pay millions to NHS while pushing products, says study
Patient Safety Learning posted a news article in News
Medical device companies are paying millions of pounds to hospitals in the UK to fund staff places, as well as training and awareness campaigns, while pushing sales of their products, including implants, heart valves and diagnostic equipment, a new report reveals. An analysis of disclosures by medical device companies found that between 2017 and 2019 they reported €425m (£367m at today’s rates) in payments to healthcare organisations in Europe, according to the study in the journal Health Policy and Technology. The businesses reported paying more than €37m to hospitals and other healthcare bodies in the UK over the three-year period. The disclosures include payments to some of the biggest hospital trusts in England. James Larkin, one of the authors of the study and a postdoctoral researcher at the Royal College of Surgeons in Ireland, said the filings did not include consultancy fees for medical staff and many companies did not register their payments. “This is just the tip of the iceberg,” he said. “There is a huge number of payments that are not being disclosed. The descriptions for payments which are disclosed are very vague and it is not completely clear what they are for.” Read full story Source: The Guardian, 20 April 2024
