Outpatient attendance payments could be combined under proposals currently being considered by Monitor’s pricing team for tariff payment changes that may come into effect from 2015-16.

Payments for outpatient attendance will be bundled up, under proposed changes to tariff payments put forward by Monitor’s pricing team.

Details of the “integrated tariff payment” proposal emerged in an update in board papers presented to the agency.

According to the plan, first and follow-up attendance payments will be combined in order to “allow providers freedom to innovate and explore alternative channels for delivering follow up care (e.g. telephone, email, group sessions)”.

The report states that an analysis of acute planned care activity variation “suggests that most expenditure growth has occurred in acute activity without national prices.

It identified outpatient follow-up activity “as an area where a change to national price-setting could possibly promote value for patients”.

The pricing team has also put together a longlist of possible local payment variations that support “service improvement and reconfiguration”.

The team’s recommendations will be delivered to the board in May.

Phillippa Hentsch, policy advisor at the Foundation Trust Network, said she had concerns about the proposal for outpatient payments

“We still need to see full details of what a new integrated tariff for outpatient appointments might involve but we have concerns around the rationale for its development” she added.

“If it’s genuinely about improving access to a range of outpatient options for patients, then the payment system might not be the best way to deliver this.

“If, on the other hand, it’s about bundling as a crude attempt at cost containment, then NHS England and Monitor need to be able to demonstrate that this won’t have a destabilising effect on providers’ income, sustainability or patient access to services.”