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Payment by Results

Volume 450: debated on Wednesday 25 October 2006

To ask the Secretary of State for Health (1) what assessment she has made of how the move to payment by results will affect the commissioning and provision of specialised services for those with long-term conditions; and if she will make a statement; (93271)

(2) what progress has been made with the implementation of the 11 quality requirements published in the National Service Framework for Long-term (Neurological) Conditions in March 2005; and if she will make a statement;

(3) what advice she has given to (a) local authority social services and (b) NHS trusts on the implementation of the National Service Framework for Long-term (Neurological) Conditions; and if she will make a statement.

Since publication of the national service framework (NSF) for long-term conditions, the Department has co-ordinated a range of activity to help local authority social care organisations and national health service bodies take forward implementation of the NSF.

This includes:

working with key NHS, social care, voluntary and independent sector stakeholders, as well as service users and carers, to identify and address key issues in neurological services and the stakeholders’ role in implementation;

ensuring that other key delivery programmes, most especially the White Paper “Our Health, Our Care, Our Say” and the long-term conditions strategy help deliver key NSF objectives; and

working with the care services improvement partnership to promote implementation of the NSF through a co-ordinated work programme, including regional workshops, a web-based getting started pack and self-assessment tool for services.

Progress on implementation will be measured in a number of ways, including:

research studies commissioned as part of a national research initiative to underpin implementation of the NSF, to provide baseline data needed to measure the subsequent impact of the NSF;

work to develop a national minimum dataset for long-term neurological conditions; and

implementation of clinical indicators developed as part of the better metrics programme.

The effect of payment by results (PbR) on specialised services for people with long-term conditions will vary. Some specialised services, such as AIDS/HIV anti-retrovirals, are not included in PbR and do not have a national tariff. Others, such as treatment for epilepsy, have a national tariff. We are always seeking to refine PbR so it provides fair reimbursement for specialist activity. To achieve this we regularly solicit feedback from the NHS and other stakeholders, including through an annual questionnaire.