Responding to reports that NHS hospitals may effectively start being paid for each patient seen or treated, Rory Deighton, senior programme lead of the NHS Confederation's Acute Network, said:

“Some hospital leaders have been asking for a return to a Payment by Results (PBR) system that encourages acute trusts to invest in new health services, new diagnostics and new ways of working. In the early 2000s, when we last made significant inroads, such a system had an important role in tackling waiting lists and could do so again as we endeavour to recover from the pandemic.

  “But it is not only hospitals and acute trusts that face huge challenges and growing waiting lists as we move beyond the peak of COVID-19 prevalence. PBR will not be enough without greater support for the whole health and social care system, and more joined-up thinking across all parts of the NHS.

 “The latest statistics on the performance of the health service in England show that our hospitals have been caring for over 12,000 patients each day who, despite being medically fit to leave hospital, cannot be discharged due in part to social care shortages which mean they cannot be adequately supported and cared for in their own homes.

  “Without a whole system approach to tackling waiting lists, and better communication with patients and the public about the scale of the challenge facing the NHS, we will see many more people turn up to places like GP surgeries, rightly demanding when their operation is due.

  “Without a whole system approach to tackling the treatment backlog, we will also see a widening of the health inequalities that have been exposed and exacerbated by COVID-19. Policies such as the introduction of patient-initiated follow-up appointments and improved digital access to information may be good ideas for enabling the health service to reduce waiting lists at pace, but they may work less effectively in more disadvantaged communities where people have access to fewer resources.

“Most importantly, the NHS urgently requires a fully costed workforce strategy, as NHS trusts are contending with nearly 100,000 vacancies. Exhausted and overstretched healthcare staff need to be given hope that help is coming.”