Exclusive: NHS England mulls specialised services payment overhaul

NHS England is considering a radical overhaul of the way specialised mental health services are paid for including a greater emphasis on rewarding providers for shifting care into the community, according to internal documents obtained by HSJ.

A paper, written for NHS England’s mental health programme of care board, which advises NHS England on commissioning policy for the sector, has set out a vision for the way tier four child and adolescent mental health services and adult secure mental health services should be paid for.

The document, obtained under the Freedom of Information Act, could see providers being paid a fixed amount for a set number of beds, with further payments for each specialised care episode and a top-up fee for reducing specialised inpatient care days.

The new model would be based on:

  • Inpatient capacity payments to maintain an agreed number of beds, irrespective of occupancy, with value set by security level;
  • A fixed fee per patient episode, where specialised care episodes for non-secure patients can be delivered in the community; and
  • A community outreach top-up fee paid for achieving a reduction in the number of specialised inpatient care-days.

Article from HSJ, 5 March 2018