NHS payments should focus on value, not single episodes of care, conference hears

BMJ 2014; 348 doi: (Published 24 January 2014) Cite this as: BMJ 2014;348:g1080
  1. Nigel Hawkes
  1. 1London

The NHS needs to focus on the value it can deliver to patients and shed its attachment to historical structures and institutions to achieve better outcomes at lower cost, a conference in London heard on 22 January.

Michael Porter, a Harvard Business School expert on healthcare, said that focusing on value to patients was “the only goal that unites all parts of the system,” encouraging cooperation, reducing fragmentation, and making the best use of every pound spent.

The NHS had been too timid about shaking up the way care was delivered and too reluctant to tell patients that for the best care they might need to travel somewhere other than their local hospital, he said. But to achieve these two objectives the NHS would have to change its payment system so that it covered “bundles” of care rather than single episodes, and it needed to collect robust outcome measures to convince doctors and …

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