Magazine article Public Finance

PBR Comes at a Price, Hospitals Told

Magazine article Public Finance

PBR Comes at a Price, Hospitals Told

Article excerpt

Payment by results might help hospital managers and clinicians to understand their costs better, but it comes with significant costs of its own, the CEPFA health finance conference heard.

Jane Tomkinson, director of finance and deputy chief executive at the Countess of Chester NHS foundation trust, told the October 5 conference in London: 'There has been a bit of an industry in just sustaining the machinations of PBR. I have to pay a significant market premium just to stop other providers poaching our skilled and experienced coding staff!

The basis for the PBR tariff of prices has been much criticised over the years, with claims that it is based on faulty estimates of the real costs of each procedure. But Tomkinson pleaded with the Department of Health to settle on a method for calculating the tariff and then to leave it be.

'Four years ago we had a £14m gain from PBR. Now that's moved to just a £2m gain. That volatility is horrendous,' she said. 'Parts of the tariffare poor and incorrect, but at least you can plan on the basis of what you know!

Tomkinsons comments came as the DoH published the draft PBR tariff for 2008/09, which will be 'road-tested over the next month. …

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