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NHS reforms 'yet to deliver'

14th February 2008

A powerful spending watchdog body has warned that efficiency reforms in the NHS are yet to deliver significant improvements in service.

Pound Coins

The Audit Commission says that despite its introduction four years ago, the Payment by Results system has not seen rises in productivity.

The system – brought in after it became clear that the price of an operation in different trusts could vary dramatically across the NHS - was designed to reward NHS hospitals for efficiency with trusts getting a national fixed price for treatments.

But because of little sign of improvement, the Audit Commission wants to see a tighter regime implemented.

The commission did find that the new system was well established and had improved financial management in some trusts. It also found that patient care had not suffered.

But chairman Michael O’Higgins said significant increases in efficiency and productivity had not yet happened, and called for “tariff? prices to be cut towards the level of the best-performing hospitals.

He said: “In order to encourage a more efficient way of working, the price that the NHS sets for procedures should be set at the lower levels that some hospitals have shown can be achieved, rather than the average cost.?

The BMA said the reform had tended to be used as a “blunt financing tool? and that there was evidence that it may interfere with clinical judgement where trusts “have put finance ahead of patient care.?

The Department of Health welcomed the report, saying it recognised the progress and benefits of Payment by Results.

 

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