The Department of Health is to review the way day case patients are funded under the payment by results tariff.
This year it introduced a new category into the tariff for “planned same day” patients, meaning trusts were paid less for treating patients as day cases than they previously were if they treated them as inpatients. Many trusts claimed it was penalising them.
In a letter to NHS managers this week, DH director general of NHS finance, performance and operations David Flory said in 2010-11 the department planned that day case procedures would be paid for under a combined day case and elective procedure tariff.
The letter also confirms the DH will introduce four “best practice” tariffs next year, which will set prices at the most efficient – as oppose to average – price for four high volume procedures. These are: cholecystectomy, fragility hip fracture, cataracts and stroke.
Meanwhile Royal College of Nursing head of policy development Howard Catton has called for trusts should be paid according to patient experience data as well as clinical outcomes.
Speaking after last week’s publication of a Patients Association report, which was highly critical of NHS nursing care standards, Mr Catton said that the system was more often to blame in such cases than bad nurses.
“We get mixed up between bad nurses and when the system doesn’t support and drive quality,” he told HSJ.
Mr Catton said the current payment by results system would not necessarily result in positive changes to patient experience, as it was only focused on rewarding good clinical outcomes. “Very simply, make the payment dependent on hospital experience,” he said.
The King’s Fund said in its response to the report that frontline staff needed more support from their senior managers. The think tank’s point of care programme director Jocelyn Cornwell said: “We need to see hospital boards, executive directors and senior doctors and nurses actively demonstrating to staff that patients’ experience of care matters.
“Boards need to take responsibility for safety and quality, and send a clear and unambiguous message to staff and patients that good care, and the people who provide it, are highly valued,” she said.