Payment by results needs evaluating

Payment by results in the NHS should only be extended to mental health services when the impact of the policy is evaluated in more depth, according to a body that
represents primary care trusts and health professionals.

The NHS Alliance said Department of Health plans to introduce payment by results (PbR), in which providers are paid for the amount of work they carry out, for mental health services could have “unintended consequences and would not represent a good return on the investment required”.

In a paper, it called for the PbR tariff for each treatment to be changed to a “ceiling price”, not a fixed, absolute price, which would allow for local negotiation on prices.

The alliance also said PbR might “inhibit” the shifting of services from acute to primary care. The Association of Directors of Social Services is opposed to the inclusion of social care within the remit of the proposed PbR for mental health, saying its rigid pricing structure is incompatible with individual budgets