PAYMENT BY RESULTS

Confirmation of Payment by Results (PbR) arrangements for 2010-11 (22nd February 2010)
The road-testing of the 2010-11 tariff and draft guidance concluded on 22 January 2010. No changes have been made to mandatory tariff prices or trim points following road-test. Details of changes have been made to some other elements of the tariff information spreadsheet.

The 2010-11 PbR guidance has been clarified in a number of areas, in response to feedback received at road-test.
Guidance

Code of conduct for Payment by Results: from 1 April 2010 (22nd February 2010)
This Code of Conduct (the Code) is aimed at all commissioners and providers, including those from the independent sector - and other bodies with regulatory and/or performance management responsibilities - operating within the PbR system, but without prejudice to any future Government decision on extending the scope of PbR. Its purpose is to establish the principles that should govern organisational behaviour under PbR and set expectations as to how the system should operate. In this way, the Code of Conduct should minimise as well as guide the resolution of disputes under PbR.
Guidance

FINANCE

NHS reference costs 2009/10: collection guidance (17th February 2010)
This document outlines the mandatory requirements for the 2009-2010 reference costs collection. It updates and supersedes previous costing guidance. It should be read in conjunction with the latest version of the NHS costing manual.
Document

NHS Costing Manual 2009-2010 (17th February 2010)
This manual sets out the principles and practice of costing to be applied in the NHS. It is not just designed to support the production of the National Schedule of Reference Costs, and through this, the national tariff, but should also be used in developing and monitoring service and financial frameworks, as well as developments in and the monitoring and implementation of National Service Frameworks.
Manual

NHS

Clarification of Complaints Regulations 2009 (28th January 2010)
New regulations for handling NHS and adult social care complaints came into effect on 1 April 2009 - however, some local provider websites are still referencing the 2004 regulations. Additionally, clarification has been provided on the legislative position around complaints being handled by PALS, and cases where legal proceedings are being taken.
Document

NHS reference costs 2008-09 (28th January 2010)
These documents provide details of how, and on what, almost £48 billion of NHS expenditure was used in the 2008-09 financial year.

As in previous years, the main purpose is to provide a basis for comparison within (and outside) the NHS between organisations, and down to the level of individual treatments.
Documents

NHS reference costs 2008-2009: Appendix DBRC Organisation Specific Reference Cost Data (28th January 2010)
This page contains the reference costs 2008-09 organisation level data that underpins the national averages. To reduce file sizes these have been zipped and are in csv format, a guidance sheet demonstrating how to upload these files into Microsoft Access is also supplied. This method of publication replaces the data DVD publication used in previous years.
Document

PAYMENT BY RESULTS

Kidney dialysis: developing costs to delivery an equitable and high quality service: final report (18th January 2010)
The working group looking at Payment by Results for renal dialysis has produced a report of its work. The report will feed into work being taken forward to develop a best practice tariff for kidney dialysis services.
Report

PAYMENT BY RESULTS

Payment by Results 2010-11 road test package (17th December 2009)
The road test exercise provides an opportunity for the service to get used to the new tariff, and supports the planning process. The main focus of the road test this year is to gather comments on the draft guidance, which has been substantially revised and expanded.
Documents

PAYMENT BY RESULTS

Payment by Results data assurance framework 2008/09 (27th August 2009)
This report presents the key findings and analysis of the 2008/09 national clinical coding audit programme managed by the Audit Commission under the Payment by Results (PbR) Data Assurance Framework.

The report shows that the number of errors made by NHS trusts under the Payment by Results (PbR) system is falling, but there are continuing concerns about the poor quality of some medical records.
Framework
PbR data assurance framework good practice and case studies
PbR results 2008/09 by organisation

Payment by Results update (14th August 2009)
This briefing details the latest PbR developments.
Update

CONSULTATIONS

PbR data assurance framework 2010/11 onwards - consultation (3rd August 2009)
The Audit Commission have launched this consultation to review the programme that has been running for three years. Some of the things that are being proposed are:

• Primary care trusts should be more integral in determining risks and the local audit programme
• Greater appreciation of local knowledge, information and management arrangements should be built into future processes
• The programme should enable the Audit Commission to discharge their responsibility to provide national assurance of the quality of data underpinning PbR and other key systems.

Closing date for comments is 2nd October 2009.
Consultation

A joint consultation on the Report to Ministers from the DH Steering Group on the Statutory Regulation of Practitioners of Acupuncture, Herbal Medicine and Other Traditional Medicine Systems Practised in the UK (3rd August 2009)
This consultation is launched jointly by the four health departments in the UK.

The consultation seeks respondents’ views on whether, and if so how, to regulate acupuncturists, herbal medicine practitioners and traditional Chinese medicine (TCM) practitioners. It focuses on the purpose of regulation – public protection - explains the difference between professional regulation (whether statutory or voluntary) and system regulation, and explores the links between the work of the DH Steering Group on the statutory regulation of acupuncture, herbal medicine and TCM and the Regulation White Paper Working Group on Extending Professional Regulation. Closing date for comments is 2nd November 2009.
Consultation

Consultation on the de-authorisation of NHS foundation trusts (27th July 2009)
The overwhelming majority of foundation trust hospitals are high performing, providing patients with the highest quality of care. But their status must always be seen as a privilege and not a one-way ticket. Foundation trusts should not retain their freedoms where they are clearly failing their patients and where a loss of public confidence has occurred. The failings at Mid Staffordshire Foundation Trust exposed a need for changes to the current regulations and the Government is therefore consulting on changes to:

• enable Monitor, in certain circumstances, to de-authorise a foundation trust and remove its foundation status, subject to agreement of the Secretary of State; and
• enable the Secretary of State, in certain circumstances, to request formally that Monitor takes specific action to intervene in or de-authorise a foundation trust. If Monitor decides not to de-authorise, or take the other action requested by the Secretary of State, then the regulator would be required to fully justify this in a written public report and set out the alternative steps it will take.

Closing date for comments is 18th September 2009.
Consultation

New Horizons: towards a shared vision for mental health - consultation (23rd July 2009)
Good mental health is fundamental to the well-being and prosperity of England. In the last decade, greater investment and reforms have transformed mental health care, but now we need to go further.

We need to target the root causes of mental illness and support the local development of higher quality, more personalised services.

New Horizons sets out ideas for achieving this. It explores the prevention of mental illness and earlier intervention when things go wrong. It also looks at how services can become more innovative and work more effectively together. Closing date for comments is 15th October 2009.
Consultation

Front-of-pack nutrition labelling for pre-packed foods sold through retail outlets in the UK (30th July 2009)
This consultation seeks views on practical issues that need to be resolved for an integrated front-of-pack nutrition labelling approach to work in real-life settings and help consumers to make healthier choices. Closing date for comments is 5th November 2009.
Consultation

MENTAL HEALTH

Joint commissioning framework for dementia (15th June 2009)
The National Dementia Strategy joint commissioning framework provides best practice guidance for commissioning dementia services. It includes a Joint Strategic Needs Assessment template, summary of NICE and SCIE evidence for dementia services, commissioning levers against each of the strategy's objectives and a summary of South East Coastal SHA dementia metrics.
Framework

Practical guide to preparing for mental health payment by results (15th June 2009)
A practical guide containing 10 actions to help local health economies prepare for mental health PbR.
Guide

Clustering booklet for use in mental health payment by results evaluation work (July-Dec 2009)
This clustering booklet contains the assessment tool (HoNOS PbR) and the 21 clusters developed by the Care Pathways and Packages Project. The clustering booklet is time-limited as work continues across the NHS to refine and validate both the assessment and the clusters. We aim to publish a revised version in December 2009 for use in 2010/11.
Booklet

Mental health payment by results: update (15th June 2009)
This letter provides an update on the latest developments on Payment by Results (PbR) for Mental Health and also clarifies the governance arrangements for this project. It is a sequel to the Department of Healths letter of 8 January 2009.
Letter

Mental Health Act 1983 Approved Clinician (General) (Amendment) Directions 2009 (12th June 2009)
Directions in exercise of the powers conferred by sections 8 and 273(1) and (4) of the National Health Service Act 2006(a), which amend the professional requirements for psychologists in Schedule 1 to the Mental Health Act 1983 Approved Clinician (General) Directions 2009.
Directions

Approved mental health professionals, approved clinicians and best interests assessors - guidance on changes to qualifying requirements for psychologists from 1 July 2009. (12th June 2009)
The introduction of the statutory regulation of psychologists from 1 July 2009 means that the qualifying requirements are changing for psychologists wishing to be approved mental health professionals (AMHPs) and approved clinicians (ACs) under the Mental Health Act 1983 or best interest assessors under the Mental Capacity Act 2005 deprivation of liberty safeguards (MCA DOLS). The Department of Health has issued the attached guidance note explaining the changes, which take effect from 1 July 2009.
Guidance

NHS

Healthcare travel costs scheme: instructions and guidance for the NHS (1st April 2009)
From 1st April 2009, provider trusts will no longer be reimbursed for Healthcare Travel Costs Scheme (HTCS) costs through the Payment by Results (PbR) tariff. HTCS expenditure should be recharged to the Primary Care Trust where the patient is ordinarily resident.
Guidance

Health Technical Memoranda Firecode 05-03 (1st April 2009)
Firecode conists of a number of Health Technical Memoranda (HTM) which consider policy, technical guidance and specialist aspects of fire precautions. Previously issued Fire Practice Notes (FPN) have been superseded and subsumed into HTMs.
HTM 05-03: Part A - Executive Summary of General Fire Safety
HTM 05-03: Part D 2nd Edition - Executive Summary of Commercial Enterprise on Healthcare Premises
HTM 05-03: Part F - Executive Summary of Arson Prevention in NHS Premises
HTM 05-03: Part K - Executive Summary of Fire Risk Assessments in Complex Healthcare Premises
Previous HTMs

PAYMENT BY RESULTS

Code of conduct for Payment by Results: from 1 April 2009 (17th March 2009)
This Code of Conduct (the Code) is aimed at all commissioners and providers, including those from the independent sector - and other bodies with regulatory and/or performance management responsibilities - operating within the PbR system, but without prejudice to any future Government decision on extending the scope of PbR. Its purpose is to estabish the principles that should govern organisational behaviour under PbR and set expectations as to how the system should operate. In this way, the Code of Conduct should minimise as well as guide the resolution of disputes under PbR.
Code of Conduct

PAYMENT BY RESULTS

Confirmation of Payment by Results (PbR) arrangements for 2009-10 (5th February 2009)

From the links below, you will be able to access information and guidance in support of Payment by Results in 2009-10.
Information and Guidance

PAYMENT BY RESULTS

Payment by Results 2009-10 road-testing package (10th December 2008)
This package is made available for the NHS to road-test the 2009-10 national tariff. Organisations need to consider all the materials provided prior to road-testing the new tariff. Key information is included in the guidance and associated annexes, which needs to be considered alongside the tariff.
Covering letter
Package

PAYMENT BY RESULTS

Payment by Results for Kidney Dialysis Project Group: interim report, June 2008 (4th September 2008)
This interim report has been produced by the renal PbR project group which has been working on the development of tariffs for renal dialysis. Guidance has been developed to inform the 2008/09 reference cost exercise and the aim is to develop a mandatory tariff for dialysis for 2010/11.
Report

PAYMENT BY RESULTS

Arrangements for market forces factor payments relating to PbR activity (21st August 2008)
This document supplements the PbR guidance published in December 2007, with which it should be used in conjunction with. The purpose of this document is to confirm and clarify the payment arrangements for the market forces factor (MFF) element for the different organisations providing elective services within the scope of PbR in 2008/09.
Document

PbR Data Assurance Framework 2007/08 (28th August 2008)
This report contains the summary analysis from the Payment by Results (PbR) clinical coding audit programme undertaken at all acute NHS trusts in England in 2007/08. The auditing of in excess of 50,000 episodes, equating to approximately GBP73 million of expenditure under PbR, provides the first comprehensive national picture of the quality of data which underpins not only financial but clinical and commissioning information.
Summary
Report

PAYMENT BY RESULTS

Ensuring PbR supports delivery of effective cancer services (7th August 2008)
The PA Consulting Group were commissioned to undertake a review of PbR tariffs and how they impact on cancer services, and how they could be best developed to support cancer services. Key findings and priorities within the report were used to inform the Cancer Reform Strategy. A copy of their full report has been made available for information purposes. The Department is currently considering the recommendations in the report. Although this report does not have an independent Equalities Impact Assessment (EQIA), it arises from work commissioned by the national Cancer Action Team and the Department of Health as part of the Cancer Reform Strategy's drive to improve cancer services and reduce inequalities in the provision of cancer care . The Cancer Reform Strategy has published a full EQIA. Any actions taken in response to the recommendations in this report will be subject to an EQIA as appropriate.
Click here for the Report

PAYMENT BY RESULTS

Code of conduct for Payment by Results (originally published 26th January – applicable from 1st April 2008)
The purpose of the Code of Conduct for Payment by Results (PbR) is to establish core principles, with some ground rules for organisational behaviour, and expectations as to how the system should operate, and to minimise disputes, as well as guide the resolution of them. PbR introduces a degree of transparency in NHS financial flows that is almost unprecedented. The new system challenges organisations to manage successfully in a dynamic environment and creates incentives for increasing productivity and making efficient use of resources. The Secretary of State requires compliance with this Code by all NHS Bodies operating PbR, including health authorities, NHS trusts and primary care trusts (PCTs).

Click here for the Code of Conduct