Main Article Content
Finance, Clinical, Payment Systems, NHS, Tariff, Blended Contract, National Tariff, Capitation, Payment By Results, HRG, Block Contract
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.
Audit Commission. Learning the lessons from financial failure in the NHS. London: Audit Commission. 2006. Available at: http://archive.audit-commission.gov.uk/auditcommission/SiteCollectionDocuments/AuditCommissionReports/NationalStudies/financial_failure_nhs.pdf
Kingsfund.org.uk. 2020 [cited 18 July 2020]. Available from: https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/financial-failurein-the-nhs-kingsfund-oct14.pdf
Lafond S, Charlesworth A, Roberts A. A Year of Plenty? An analysis of NHS finances and consultant productivity.
Health Foundation; 2017. Available from: www.health.org.uk/sites/health/files/YearOfPlenty.pdf
National tariff payment system | NHS Improvement www.Improvement.nhs.uk. 2020 [cited 29 July 2020]. Available from: https://improvement.nhs.uk/resources/national-tariff/
Improvement.nhs.uk. 2020 [cited 18 July 2020]. Available from: https://improvement.nhs.uk/documents/216/Annex_A_National_Tariff_workbook_1.xlsx
Jamie G. UK - QOF Database [Internet]. Gpcontract.co.uk. 2020 [cited 29 July 2020]. Available from: https://www.
Quality and outcomes framework (QOF) [Internet]. The British Medical Association is the trade union and professional body for doctors in the UK. 2020 [cited 29 July 2020]. Available from: https://www.bma.org.uk/advice-and-support/gp-practices/funding-and-contracts/quality-and-outcomes-framework-qof
GP funding and contracts explained [Internet]. The King’s Fund. 2020 [cited 29 July 2020]. Available from: https://www.kingsfund.org.uk/publications/gp-funding-andcontracts-explained
Primary care networks explained [Internet]. The King’s Fund. 2020 [cited 29 July 2020]. Available from: https://www.kingsfund.org.uk/publications/primary-carenetworks-explained
2019/20 payment reform proposals | NHS Improvement. Improvement.nhs.uk. 2020 [cited 18 July 2020]. Available from: https://improvement.nhs.uk/resources/201920-payment-reform-proposals/