Key points

There are eight principles that a payment system should incorporate if it is to support providers in delivering high quality care:

  1. Clear purpose
  2. Realistic expectations about impact
  3. National consistency with local flexibility
  4. Appropriate, aligned incentives
  5. High quality data 
  6. Balance between complexity of design and ease of use
  7. Independent oversight and support
  8. Time to embed and evaluate systems

The Health Foundation and NHS Providers have investigated how current payment systems impact on those providing care to patients by considering what works well and what problems they encounter. 

Following extensive engagement with NHS trusts – providers of acute, mental health, community and ambulance services – this report identifies eight guiding principles that a payment system should meet if it is to support providers in delivering high quality care. 

These principles reflect the views of those responsible for providing care to patients, and are presented with the aim of informing future evolutions of the payment system that support the provision of high quality services.

    Further reading


    The future of the NHS hospital payment system in England

    July 2021

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