NHS payment reform: lessons from the past and directions for the future

This policy response reviews different approaches to payment for health services in the English NHS.

The health service has historically been a leader among public services in embracing innovation in payment systems. A wide range of different approaches to payment are now in place for different sectors and different areas, often introduced specifically to drive quality, volume or productivity improvements.

If the NHS is to improve the efficiency of the health system as a whole, it needs payment systems that cover the continuum of care and which create incentives for providing the ‘right care in the right setting
 Anita Charlesworth, Chief Economist, Nuffield Trust and co-author

This policy response looks at options for development of the payment reform system in England. It recommends that any changes are targeted on where they are likely to have the greatest impact, and aligned with wider system changes. The authors also call for any changes to be transparent and evidence-based, as well as predictable and credible.

This policy response is published alongside a research report, The NHS payment system: evolving policy and emerging evidence, which looks at the evidence on whether recent payment initiatives have met their goals.

Suggested citation

Charlesworth A, Hawkins L and Marshall L (2014) NHS payment reform: lessons from the past and directions for the future. Research report. Nuffield Trust.