Health secretary Andrew Lansley has laid out his plans for a best practice tariff, aimed at encouraging greater patient choice and control.

In a speech to the Nuffield Trust summit this afternoon, Andrew Lansley said Payment by Results was “misleading” as it does not reward organisations for results.

“They are rewarded for processes and ticking boxes, for doing stuff and not actually for delivering the best possible patient care”, he said.

During a Q&A session Mr Lansley also claimed in future there will be “less price competition than there is now” because more treatments will be covered by the tariff and therefore there will be fewer block contracts, which effectively allow providers to compete on price.

He said the government planned to introduce a further 18 best practice tariffs in 2011-12. One will be for “mini-strokes”, or transient ischemic attacks, he said.

Mr Lansley said payment would be “aligned” with National Institute for Health and Clinical Excellence (NICE) guidelines so that levels of payment will rely on meeting quality standards.

He said that while current payments based on historic average treatment costs “can’t hope to keep up” with developments in care, where best practice tariffs are introduced “we won’t wait for the cost data to catch up”.

He said commissioners could pay for “pathways of care” which would involve up-front payment.

For example, he said, maternity providers could be given a fixed amount up front based on a risk assessment to provide for all or part of a woman’s care. He said this would lead to a pro-active approach and encourage providers to “prevent the need for any avoidable interventions”.

He said that a year-long care pathway for Cystic Fybrosis would set out “all aspects of the support that an individual will need over the course of 12 months”.

“These changes are about getting the right financial system in place to support the very best patient care and to offer greater patient choice and control”, he said.

Mr Lansley also said: I don’t believe that in the future, modern health service, a politican should be in control.  Leadership should come from within the NHS .