3. SYSTEM REFORM
3.1.7 Can the Department provide a commentary
on what Payment by Results has achieved so far with regard to
unit costs, length of stay and volumes of care? (Q26)
Answer
1. The Department commissioned an independent,
national evaluation of the implementation and effectiveness of
payment by results (PbR) from the Health Economics Research Unit
(HERU) at the University of Aberdeen, supported by the Office
of Health Economics in London and the University of Dundee.[6]
2. The aims of the project were to examine
the process of implementation and the effect of the introduction
of PbR on key outcomes such as activity and efficiency. The project
focused on the early years of implementation, with information
gathering beginning in mid-2005 and concluding in mid-2007.
3. The study used data from Scotland (where
PbR has not been implemented) as a "control group" against
which to compare data from England (where PbR has been implemented),
and found that where PbR has been implemented:
— there is evidence of reductions in unit
costs of care;
— there is evidence of reductions in lengths
of stay; and
— there is slight evidence of growth in
volume of activity.
4. The Department has asked HERU to extend
their analysis using more recent data. Their first report should
be available later in 2009.
5. The Audit Commission have also published
a report on PbR, The Right Result? PbR 2003-2007 (February
2008).[7]
This report notes that its "findings are similar to analyses
undertaken by the Health Economics Research Unit (HERU)".
6 HERU's report, National Evaluation of Payment
by Results (November 2007), is available at:
http://www.dh.gov.uk/en/Managingyourorganisation/Financeandplanning/NHSFinancialReforms/DH_4138133 Back
7
Report available at:
http://www.audit-commission.gov.uk/nationalstudies/health/financialmanagement/Pages/therightresult.aspx. Back
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