PBR confusion leaves trusts in limbo

20 Jan 05
A delay in the introduction of NHS payment by results has left foundation trusts in financial limbo and unable to plan for the new financial year.

21 January 2005

A delay in the introduction of NHS payment by results has left foundation trusts in financial limbo and unable to plan for the new financial year.

Last week the Department of Health announced that from April payment by results would cover only elective admissions (around 30% of trusts' income) in non-foundation trusts. It had planned to widen the scope of PBR to around 70% of trusts' income by including emergency and outpatient cases, but this will not now happen until April 2006.

The department said emergency and outpatient activity was too unstable, following a big increase in short-stay emergency admissions. Tariffs based on activity in these areas would not be sufficiently reliable.

It appeared that foundation trusts – which are further ahead in implementing PBR – would carry on with the planned extension of the scheme.

But foundation trust sources contacted by Public Finance this week said there was confusion over which elements would be compulsory.

Many assumed they would not have to apply PBR to the most unpredictable elements of their work, including A&E and short stay admissions. Some asked whether they would be expected to use an 'unreliable' tariff if they were to apply PBR to these areas.

The confusion meant they could not plan for 2005/06 as they could not calculate their income. The DoH is due to produce guidance on the issue soon.

Despite the uncertainty, Health Secretary John Reid approved the provisional applications of a further 32 trusts seeking foundation status including, for the first time, mental health trusts.

The 32 will submit more detailed applications and should Reid accept these, they will be forwarded to the foundation regulator, Monitor, for approval.

Monitor is expected to award foundation status to successful applicants from this group from spring 2006.

Tony Gardner, chief executive of Cornwall Partnership NHS Trust, one of the eight mental health trusts to be shortlisted, said: 'Through foundation status…we can become more responsive and better able to deliver the local services that people really want, accountable to local need rather than central government control.'

PFjan2005

Did you enjoy this article?

AddToAny

Top