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December 2011
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Payment by Results for chemotherapy—challenges and solutions
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Key Points
• Chemotherapy is scheduled to come under the umbrella of Payment by Results
• There remain several obstacles, but plans are in place to address these
• Because there is a 3-year lag time between reference cost reporting and tariff setting, we are unlikely to see a chemotherapy tariff before 2012
Introduction
Payment by Results (PbR) has been in use within the National Health Service (NHS) since 2003–04.
At first, its application was generally restricted to inpatient surgical services, but the Department of
Health (DH) is working to introduce PbR to other clinical areas—including chemotherapy.1 This article considers the progress that has been made so far towards a chemotherapy tariff for PbR, the challenges still faced, and the plans in place to tackle them.
What is Payment by Results?
Unlike block contracts or cost-and-volume contracts, PbR means that payment is made (by NHS purchasers) for services actually performed (by NHS providers). It offers several advantages over traditional contracts, but is also associated with some risks (Panel 1).
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Discussion.