Payment by results for fractured neck of femur in two NHS Secondary Care Trusts

The NHS is in the midst of widespread financial and personnel restructuring. A cost-efficient organisation with effective Secondary Care Trust payment structure was envisaged in the government paper Delivering the NHS Plan. Payment by results (PbR) was introduced into the NHS in 2004 in an effort to finance Trusts fairly and reward work volume. PbR is a cost-per-case fixed national payment system based on Healthcare Resource Groups (HRG). A reduction in waiting times, increased productivity and better use of capacity are expected benefits. An improvement in data collection is anticipated. Similar payment structures are used in Europe, the US and Australia. PbR aims to create an individual tariff for each hospital patient episode. Primary Care Trusts (PCTs) will pay this tariff for the treatment of each individual patient in their resident population.