The NHS payment system: evolving policy and emerging evidence

This research report reviews different approaches to payment for health services in the English NHS.


Published: 20/02/2014

ISBN: 978-1-905030-76-7

Download the report [PDF 681.2KB]

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.

As Monitor and NHS England develop the NHS payment system, it is important that any immediate changes made to the payment system are in line with the direction of longer-term changes. Stability is important to both providers and commissioners Anita Charlesworth, Chief Economist, Nuffield Trust and report co-author

This research report takes a comprehensive look at different approaches to payment and how they function in the English NHS. It brings together and summarises the available evidence on whether recent payment initiatives have met their goals.

It is published alongside a policy response, NHS payment reform: lessons from the past and directions for the future, which gives key recommendations on what is possible through short and long-term payment reform.

Suggested citation

Marshall L, Charlesworth A and Hurst J (2014) The NHS payment system: evolving policy and emerging evidence. Research report. Nuffield Trust.