Who Pays for What proposals

Who Pays for What proposals
NHSX 31 August 2021

• A description of the barriers to investment in digital technology and how NHSx propose to start to fix them in 2021 to 2022 and beyond to support ICSs. 
• Part of NHSX Digitise, connect, transform: Guidelines for digitised healthcare

NHS environmental sustainability guidance map

NHS environmental sustainability guidance map
HFMA 23 August 2021 

• Aimed at all those working in the NHS, in particular NHS boards, finance teams and clinical colleagues, the purpose of this map is to highlight the published resources that support the development of environmental sustainability in the NHS. The map brings together the key guidance, tools and examples to support the NHS in meeting its commitments to environment sustainability

The Cost of Inequality - putting a price on health

The Cost of Inequality - putting a price on health
Centre for the Study of Financial Innovation June 2021

• This paper challenges the conventional wisdom by proposing a novel way of thinking about inequalities that links health to wealth and to the economy. What is new about the methodology applied in this study is the way we measure the scale of this inequality. We do this by imagining a situation in which each local area is responsible for financing its own public services and that the tax base is people’s earnings.

Translating economic evaluations into financing strategies for implementing evidence-based practices.

Translating economic evaluations into financing strategies for implementing evidence-based practices. Implementation Sci 16, 66 (2021). https://doi.org/10.1186/s13012-021-01137-9

• Implementation researchers are increasingly using economic evaluation to explore the benefits produced by implementing evidence-based practices (EBPs) in healthcare settings. However, the findings of typical economic evaluations (e.g., based on clinical trials) are rarely sufficient to inform decisions about how health service organizations and policymakers should finance investments in EBPs. This paper describes how economic evaluations can be translated into policy and practice through complementary research on financing strategies that support EBP implementation and sustainment.

NHS finance explained: How money flows in the NHS [YouTube]

NHS finance explained: How money flows in the NHS [YouTube]
NHS Future-Focused Finance 21 April 2021

• An animation giving an overview of the structure of the NHS in England and description of how the money flows.

Financial Incentives and Prescribing Behaviour in Primary Care

Financial Incentives and Prescribing Behaviour in Primary Care
Centre for Health Economics Research Paper 181 April 2021

• Many healthcare systems prohibit primary care physicians from dispensing the drugs they prescribe due to concerns that this encourages excessive, ineffective or unnecessarily costly prescribing. Using data from the English National Health Service for 2011 to 2018, we estimate the impact of physician dispensing rights on prescribing behaviour at the extensive margin (comparing practices that dispense and those that do not) and the intensive margin (comparing practices with different proportions of patients to whom they dispense). We show that physician dispensing raises drug costs per patient by 4.2%, which reflects more and more expensive drugs being prescribed, including potentially inappropriate substances such as opioids. Dispensing practices also prescribe smaller packages as reimbursement is partly based on a fixed fee per prescription dispensed.

Publicly funded hospital care: expenditure growth and its determinants

Publicly funded hospital care: expenditure growth and its determinants
Centre for Health Economics 19 January 2021

• Understanding the drivers of growth in health care expenditure is crucial for forecasting future health care requirements and for the efficient use of resources. This paper considers total hospital admitted care expenditure in England between 2009/10 and 2016/17.

Unit Costs of Health and Social Care 2020

Unit Costs of Health and Social Care 2020
Personal Social Services Research Unit, University of Kent, December 2020

• This annual report consists of tables of unit costs for approaching 100 types of health and social care services. 
• Includes: Economic evaluation methods in social care: A scoping review. 
• This article summarises the methods used in published economic evaluations of social care interventions, briefly noting some recent methods developments, and it highlights key methods issues and gaps for addressing in the future.

Organisation change - case studies from finance teams

Dealing with organisational change – case studies from the finance team of the year award 2019
HRMA September 2020

• This briefing shares the experiences of finance teams in supporting significant organisational change in Hampshire and Isle of Wight Partnership of CCGs; Pennine Care NHS Foundation Trust; and Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust.

Understanding resource consumption across a system

Understanding resource consumption across a system

Healthcare Financial Management Association (HFMA) 2 September 2020

• This case study describes how the Derbyshire health and care system set about linking up data from four providers, including establishing data sharing agreements, so that they had a better understanding of the use of resources across the system. 
• This briefing also includes experiences from Gloucestershire ICS as they look at how data can be used to inform where resources can best be directed to improve population health.

HFMA Covid-19 guidance map

Covid-19 guidance map
HFMA updated 28 August 2020

• The HFMA has produced a Covid-19 guidance map which brings together the key guidance to support NHS finance and governance professionals as they respond to the current pandemic. The Covid-19 guidance map is split into six key sections: financial arrangements; financial governance; annual accounts and annual report 2019/20; fraud prevention; workforce; and further information on Covid-19 developments.

Who Pays? Determining responsibility for NHS payments to providers

Who Pays? Determining responsibility for NHS payments to providers
NHS England 26 August 2020

• This revised Who Pays? guidance sets out a framework, for the NHS in England for establishing which NHS organisation has responsibility for commissioning an individual’s care and which has responsibility for paying for that care.  It clarifies responsibilities for funding care on discharge from hospital and sets out a mandatory dispute resolution process.  
• It is published for implementation by commissioners from 1 September 2020.

Spend and outcome tool (SPOT) for public health

Spend and outcome tool (SPOT)
PHE Updated 23 July 2020

• Using the SPOT, public health teams and commissioners can:
• compare spend and outcome measures against other local authorities including Chartered Institute of Public Finance and Accountancy (CIPFA) statistical neighbours
• look at spend and outcome measures across a range of public health areas, as well as other local authority spending areas
• identify programmes with outcomes significantly different to similar local authorities that may need more analysis use the tool alongside return on investment and health economics tools
• Update July 2020 - 
• SPOT to CCGs tool is no longer being updated due to the lack of available CCG spend data.

Health and social care costs of a selection of health conditions

Health and social care costs of a selection of health conditions
PHE 7 July 2020

• This report sets out the estimated health and social care cost per case figures of a selection of common health conditions and multimorbidities. The associated technical appendix gives additional detail of the methodologies used.
• The health conditions studied were: • COPD • diabetes (Type 1 and 2)2 • lung cancer • breast cancer • coronary heart disease (CHD) • stroke • hypertension • dementia • liver disease • depression • colorectal cancer

Guide for Audit and Risk Committees on Financial Reporting and Management during COVID-19

Guide for Audit and Risk Committees on Financial Reporting and Management during COVID-19
NAO 24 June 2020

• This guide aims to help audit and risk committee members discharge their responsibilities in several different areas, and to examine the impacts on their organisations of the COVID-19 outbreak, including on: annual reports; financial reporting; the control environment; and regularity of expenditure.

Health economics: a guide for public health teams

Health economics: a guide for public health teams
PHE updated 18 June 2020

• Links to tools and reports that can help you:
• assess which interventions provide the best value for money, by calculating their costs, benefits and ROI
• make the most of your budget by deciding how to split resources across different public health programmes
• compare costs, savings and clinical outcomes
• assess the available economic evidence in different public health topic areas
• Covers a range of health conditions including LTCs and public health concerns (eg falls) plus wider decision support.
• ROI tools include:
• colorectal cancer ROI tool
• end of life care economic tool
• NHS Diabetes Prevention Programme ROI tool

GP funding and contracts explained

GP funding and contracts explained
Kings Fund 11 June 2020

• This explainer sets out how general practices are contracted and paid in England, looking at the services they are contracted to deliver, and the different streams of funding they receive.

2019/20 annual report and accounts checklist

2019/20 annual report and accounts checklist
HFMA Updated 8 June 2020

• This checklist is intended to be a simple way of identifying, on a line by line basis, the issues that were expected to have an impact on the 2019/20 annual report and accounts both prior to the Covid-19 pandemic as well as those that have arisen as a result of the pandemic. The checklist will be updated and revised up to the submission deadline on 25 June.

HFMA directory of resources

HFMA directory of resources
20 May 2020

• An overview of all the support available from the HFMA and Future-Focused Finance, signposting the resources available to our members and the wider NHS finance community

How is the NHS structured? - funding and regulation

How is the NHS structured?
Kings Fund 8 April 2020

• Infographics and videos explaining how funding flows in the NHS and how providers are regulated and commissioned.