Outcome-based payment schemes: government’s use of payment by results

"This report highlights lessons on the selection and implementation of PbR in the UK public sector. Its intended main audience is commissioners and senior decision-makers within departments, as well as officials at the centre of government with an interest in public service delivery models."

Outcome-based payment schemes: government’s use of payment by results
National Audit Office
June 2015

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Emerging practice in outcome-based commissioning for social care

"This paper is a progress report exploring the lessons learnt from a variety of approaches taken by councils to “outcome-based commissioning” in adult social care (sometimes called 'payment by results').  It considers some of the opportunities and risks that arise from taking this approach."

Emerging practice in outcome-based commissioning for social care
J Bolton
Institute of Public Care, Oxford Brookes University
April 2015

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Improving inpatient care with the introduction of a hip fracture pathway

"A system of payment by results exists for the management of hip fractures in England and Wales. Poor performance against the national standards was noted, reflecting failure to deliver optimal care. Through the introduction of a multi-disciplinary patient pathway and clerking pro forma, the proportion of patients earning the best practice tariff uplift increased from 44.4% to 91.7%. "

Improving inpatient care with the introduction of a hip fracture pathway
M Chamberlain, H Pugh
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u204075.w2786

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The quality of clinical coding in the NHS

"Throughout the assurance framework we have identified consistent issues that impact on data quality. We have developed these themes using the learning from this year’s audit programme into a checklist of 10 areas designed to enable senior managers to identify ways of improving and maintaining the quality of clinical coded data."

The quality of clinical coding in the NHS: Payment by Results data assurance framework
CAPITA
Department of Health
September 2014

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Improving the accuracy of operation coding in surgical discharge summaries

" We suggest that specifically designed coding tables be introduced across each surgical department to ensure accurate OPCS codes are used to produce better quality surgical discharge summaries and to ensure correct reimbursement to the Trust."

Improving the accuracy of operation coding in surgical discharge summaries
E Martinou, G Shouls, N Betambeau
BMJ Quality Improvement Reports 2014;3

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The NHS payment system: evolving policy and emerging evidence

"This research report takes a comprehensive look at different approaches to payment and how they function in the English NHS. It then brings together and summarises the available evidence on whether recent payment initiatives have met their goals."

The NHS payment system: evolving policy and emerging evidence
L Marshall, A Charlesworth, J Hurst
Nuffield Trust
February 2014

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NHS payment reform: lessons from the past and directions for the future

"To ensure that the long-term reforms to the payment system support the NHS to deliver efficient, high-quality care, Monitor and NHS England need to develop an approach that is:

• Comprehensive.
• Focused
• Aligned with wider system changes
• Transparent and evidence-based
• Predictable and credible"

NHS payment reform: lessons from the past and directions for the future
A Charlesworth, L Hawkins, L Marshall
Nuffield Trust
February 2014

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How can the NHS payment system do more for patients?

"Part One of this document gives the context for this discussion and Part Two describes the development of the NHS payment system to date. Some early ideas on how to design a payment system for the longer term are set out in Part Three for discussion with the sector, with a view to publishing a long-term strategy incorporating stakeholders’ contributions by the end of the year."

How can the NHS payment system do more for patients? A discussion paper
Monitor, NHS England
May 2013

Read more here.

The response form for this discussion paper is available here.

How can payment systems help to deliver better care?

"Based on a review of the English NHS experience of Payment by Results (PbR) and international experience of similar, activity-based payment systems, this report identifies five general lessons about payment systems, draws some conclusions about whether our current Payment by Results system is fit for purpose in view of current and future challenges and presents options for how reforms to PbR could be taken forward."

Payment by results: how can payment systems help to deliver better care?
J Appleby, T Harrison, L Hawkins, A Dixon
The King's Fund
October 2012

Read more here.