What would be the unintended consequences of heavy-handed tinkering with PBR?
SS: Well, any time you play around with PBR you risk new unintended consequences. But that doesn’t mean it should be frozen in time. PBR is well-suited for the tasks it has been set – for example it helps offset the fact that in many parts of the country, PCTs face one or two dominant local providers with significant ‘market power’ and ‘pricing power’. By taking unit price off the table, PBR allows commissioners to focus on utilisation and quality. But clearly, downward pressure on unit prices via the tariff system cannot by itself satisfactorily tackle the oncoming financial pressures in the NHS. HPI: What are the key characteristics needed in the DH senior management team to successfully steer the NHS through the next rather choppy bit of water? “There clearly needs to be a compelling conversation with the public about how – given national financial circumstances – difficult changes will be required in the NHS. This conversation can’t purely be left to the politicians.” SS: There cle
