Payments Systems in the NHS

Abstract

Finance within the NHS is poorly understood by clinicians and the limited engagement of clinical leaders in finance decisions is recognised as a common pitfall in recent inquiries such as the Francis report¹ and recent King’s Fund report into financial failure². The complexity and rapidly changing landscape of financing systems in place across the NHS on a background of complex and transient organisational structure makes it challenging for the patient focused clinician to achieve a working knowledge of finance. This article will discuss various payment mechanism and explore their advantages and disadvantages and then discuss how they have been used on their own or in combination to fund healthcare organisations. In order to provide context for clinicians, we will discuss how the payment contracts influence day to day health service practice.