The NHS payment system has evolved over years into a complex mix of methods, prices, incentives and penalties. It is the product of over a decade of reforms to different components. Aspects of NHS payment systems may act as barriers, whether to service transformation, achieving more integrated care or other ambitions for care more suited to an ageing population in the face of an NHS funding crisis.
“NHS England and Monitor want a reformed payment system to help tackle some of the biggest challenges facing the NHS, including joining up care across sectors, and shifting care out of hospitals into the community”.
Two linked reports review the evidence from evaluations of NHS payment systems and make recommendations to Monitor and NHS England for reform.
Can payment reform promote better care? London: Nuffield Trust, February 2014.
The first Nuffield Trust report reviews different approaches to payment for health services in the English NHS. It explores whether recent payment initiatives have had the intended results.
Marshall, L. Charlesworth, A. [and] Hurst, J. (2014). The NHS payment system: evolving policy and emerging evidence. London: Nuffield Trust, February 2014.
A range of different approaches to payment across different sectors and different areas have been introduced variously to drive quality improvements, the volume of activity and / or greater efficiency and productivity improvements. The companion Nuffield Trust report explores the evidence on whether recent payment initiatives actually meet NHS goals and ambitions.
Charlesworth, A. Hurst, J. [and] Marshall, L. (2014). NHS payment reform: lessons from the past and directions for the future. London: Nuffield Trust, February 2014.
The NHS Payment System: Prices for NHS-Funded Healthcare
Monitor has published guidance (and a consultation) on the NHS payment system.
2015/16 National Tariff Payment System: national prices methodology discussion paper. London: Monitor and NHS England, April 25th 2014.