Making Outcome-Based Payment a Reality in the NHS

The second phase of the research undertaken by the Office of Health Economics, RAND Europe, University College London and Manchester University was published in November 2021. It sought to understand the extent of existing NHS data capture on these key outcomes and whether these data are in a form suitable for a national-level outcome-based payment (OBP) scheme. The report found that the outlook on data availability for OBP is positive for clinical outcomes such as survival and disease progression, but that improvements are still needed to capture data on patients' ability to return to normal activities and their long-term side effects—and to optimise and link these datasets to enable financial decisions.

The research also explored wider practical considerations for implementing OBP schemes in the NHS and found that these mainly relate to agreeing the rebate process and achieving buy-in from clinical staff, Trusts executives, and national system stakeholders.

We will soon begin exploring possibilities for convening relevant stakeholders, to discuss how these challenges can be overcome and recommendations implemented to develop the evidence-base further to understand the viability of OBP schemes in the future.

A supplementary report is also available.