Richard Russell
Leeds
Having worked for an Acute Trust, PCT, SHA and Department of Health I have seen how the NHS works, from a practical perspective, at all levels.
I bring this practical experience and my Payment by Results expert knowledge to provider support from resolving queries/disputes, training, developing new prices etc. See www.rsrconsultants.com for more information.
Recent activity
Comments (113)
-
Comment on: Caldicott expected to raise legal doubts over CSU data services
For Payment by Results to work organisations have to start using the same identifier across providers - i.e. NHS Number. For example - take the maternity pathway - only one provider (i.e. the "lead" provider) gets the money from the commissioner to deliver the pathway and then if any other providers are involved they have to subcontract with the "lead" provider to get it. So commissioners need NHS numbers for women on the antenatal pathway so if they are billed by the non "lead" provider they can pass the bill on to the "lead" to resolve. Without the NHS number they can't actually do this validation. This would mean that the IC would not just hold the information but also do all of the locally designed validation tests, KPI tests and so on... it is not just a simple matter of providing pseduonomised reports to the CSU/CCG...
-
Comment on: Warning on patient care 'rationing'
The NHS has a fixed amount of cash available to it and so we are always rationing healthcare in order to live within this. Just look at IVF treatment - NICE says offer up to three cycles whilst most PCTs only off one.
-
Comment on: Three quarters of first wave CCGs given authorisation 'conditions'
What does "Decision sign off or approval by the NHS CB" mean?
-
Comment on: North Staffordshire facing shock £23m deficit
The article says "By October the trust had overspent by £21.4m on its operating expenses. It blamed this on a 15 per cent rise in accident and emergency attendances and non-elective admissions." How much money did the 15% rise in activity bring with it? Typically PbR is full cost when additional activity is marginal cost so a rise in activity should come with a rise in profitability - I wonder what is going wrong...
-
Comment on: It's time to rethink payment by results
PbR is purely a tool, and a blunt one at that. It is how it is used and the other KPIs/Outcome measures that sit alongside it that makes it work. When used well it can work wonders. However, where I have seen relationships deteriorate then PbR can become a tool used to beat the other party with. I think the above would be true of any payment mechanism though. There is already loads of flexibility in PbR so let's use it rather than undo all the lessons already learned...
