News / HFMA and Fund set out payment reform aims
By Steve Brown
The HFMA and the King’s Fund have set out the key characteristics that should underpin a revised payment system.
The joint briefing, based on a practitioner workshop organised by the two bodies in conjunction with Monitor at the beginning of the summer, aims to inform the current review of payment systems being undertaken by Monitor and NHS England. The briefing called for a new system to provide full coverage of payments between commissioners and secondary and tertiary providers and to encourage whole system working.
It also backed greater links between payment and outcomes – although there are challenges in implementing such an approach – and a system that incentivised the transformation of services. The system also needs to be rules-based and support longer term planning.
Tony Whitfield, president of the HFMA, and director of finance and deputy chief executive at Salford Royal NHS Foundation Trust said payment systems need to make change possible and not act as an obstacle to reform. ‘Payment by results (PBR) has delivered significant benefits since its introduction but, for example, it could do more to support more integrated care,’ he said. ‘We need to keep what works well with the current system, but think very carefully about what we need going forward.’
Mr Whitfield added that a rules-based system covering all activity did not mean national prices for everything or a single model for payment. ‘We need flexibility in the way the NHS pays for the mixture of services offered to patients.’ Writing in this month’s Healthcare Finance (‘Food for thought’, page 10), he underlined that the finance function had a major role to play in informing and designing a new payment system.
John Appleby, chief economist at The King’s Fund said the current payment system may be obstructing much needed service change in some areas.
‘One size does not fit all when it comes to payment systems,’ he said. ‘Radical changes in the blend of payment methods used in the NHS are essential to improve NHS performance and the quality of patient care.’
 HFMA briefings
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