Report comment

Anon 1:13 The PbR tariff for a Follow Up appointment is deliberately set at slightly less than the average cost. Therefore providers already have a build in financial incentive in the tariff to reduce "unnecessary" Follow Ups. One that costs providers and commissioners nothing to administer. Why do you need another layer on top which costs (in admin time) on top to administer?

If the benchmarks used for setting New to Follow Up rates where clinically determined and sensitive to local circumstances (e.g. local primary care services) then you might have a point. But they're not. They also ignore the fact that success if it comes in the form of averting unnecessary referrals to hospital result in fewer New appointments but a HIGHER proportion of Follow Ups. It is not true that lower Follow Up rates always equal better service (in financial or clinical terms).

My truck is not with PbR structures or tariff levels, which already build in financial incentives to improve year on year efficiency. Nor do I have a problem with sensibly set targets aimed at improving quality (with financial penalties for failure). But I do have a problem with commissioners expecting to pay less than PbR tariff for a service.