News / Prime minister signals link to outcomes

In a speech to the House of Commons on the draft legislative programme for the coming parliament, Mr Brown said the NHS would introduce P4P in order to improve quality.

‘Responding to user satisfaction is now commonplace in the private sector and whilst many NHS trusts do this well, they are not financially incentivised to do so. So we will increasingly base payments to hospitals on patient reported outcomes and patient satisfaction,’ he said.

A number of finance managers contacted by Healthcare Finance backed the aim of paying for results not just activity, but raised concerns about how the system might work. Some suggested the Department might simply extend its ‘fine system’, introduced around 18 week waits and hospital acquired infections, while others called for any future system to be based on positive incentives rather than penalties.

There were also concerns around the speed of introduction, with some managers believing the focus should be on getting the current system working properly first and expanding to other key service areas, before changing the system in one area. The were also concerns about using subjective measures, with some preferring the adoption of local systems rather than a national model.

The announcement came as a report from the Nuffield Trust called on the NHS to ‘go slow’ on plans to encourage quality improvements using financial incentives.