The man leading NHS England’s review of urgent and emergency services in England has said an activity-based funding model was “wrong”.
Keith Willett, national director for acute episodes of care, said he was speaking in a personal capacity rather than pre-judging the results of the review, but that the fragmentation of the current system meant the activity-based payment system was inappropriate.
His comments, to a session at the Foundation Trust Network conference in Liverpool, came after documents relating to the joint NHS England/Monitor consultation on tariff for 2014-15 were released last week. They said the bodies would examine whether the tariff was appropriate for A&E in the subsequent financial year.
Professor Willett said the current system led to an “adversarial” relationship between hospitals and the rest of the system.
HSJ understands the review of urgent and emergency services, which is the overall responsibility of NHS England medical director Sir Bruce Keogh, is due out in November.
It will follow the Department of Health-authored policy document on the care of the vulnerable older people earlier in the month.
The session also saw presentations from Michael Scott, chief executive of Norfolk Community Health and Care Trust, who argued for a capitated model of funding for the services, saying his organisation had bid to run older people’s services in Cambridgeshire on this basis.
He also said block contracts “blocked innovation” in the sector because hospital trusts were paid by activity and community trusts were not.
Mr Scott argued for “community services to be delivered in bulk” but that this “just doesn’t exist at the moment.”
Barbara Green, interim head of strategy at the London Ambulance Service Trust, told the session call volume was going up by 4 per cent a year at her organisation.
She said the groups most reponsible for the increase were 21 to 30-year-olds and 71 to 80-year-olds.
Ms Green added that her trust was trialling work around “intelligent conveyancing”, which aims to predict patterns of calls earlier in the day to avoid ambulance diverts.