01 April 2005
The NHS Confederation has called for payment by results to be introduced for accident and emergency care after MPs criticised casualty services this week.
The Commons' Public Accounts Committee said that demand for care at A&E had continued to rise, despite the government's introduction of 63 community drop-in clinics and services such as NHS Direct. Daily demand was now 3% higher than last year.
Nigel Edwards, the confederation's director of policy, said: 'Practice is running ahead of policy in a number of places and the shape of A&E and urgent care is likely to change enormously in the next five years.'
But such integration of services needed a supportive financial system. 'We urge the Department of Health to develop the payment by results model so that it offers an incentive for delivering integrated emergency care,' he said.
Payment by results gives primary care trusts an incentive to develop alternative community services, often cheaper and more popular with patients as they are closer to their homes.
The PAC report found that while 95% of trusts had met the four-hour waiting target during the department's spot checks, just 70 trusts – fewer than half – were achieving it every week.
PAC chair Edward Leigh said: 'The picture is less rosy than it seems. Shortages of specialist staff mean that key patient groups, such as older people and people with mental health problems, are still waiting the longest.'
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