Headlines: February 16th, 2005

A bonus payment scheme for consultants and other staff is to be piloted in the diagnostic sector to help speed up diagnostic tests. The scheme known as ‘Fee for Service’ was introduced for operations and outpatient consultations in some 30 NHS Trusts last October. Payment depends on performance on top of the volumes that would normally be expected. Six pilot sites will be selected for the diagnostic tests trial.The bonus scheme is used by hospitals to help transform the way patient care is delivered, improve efficiency and create extra capacity. It already covers a range of treatments, including orthopaedics, ophthalmology and general surgery. It is being used, for example, to facilitate the provision of an in-house dermatology telemedicine service. Although the clinical model of telemedicine was already established within the Trust, the scheme encouraged dermatology staff to undertake additional elements of work and further improve delivery of a quality service.

The Fee for Service Programme creates incentive structures that fit individual needs. In some pilots, clinical teams received a fixed sum of money for each additional operation completed, while in other pilots bonuses are paid to whole teams and the funding used to purchase extra equipment.

The initial evaluation of the pilots shows that the new ways of working have made a significant impact in helping to reduce waiting times.