1. A promising start More to do Where do we go from here? Chris Newton
Payment by Results
A promising start
More to do
Where do we go from here?
Chris Newton

2. Remaining issues for our service
Consistent and accurate data collection
Renal Transplantation: possibly already picked up by existing PbR
AKI: also being considered by Greater Manchester critical care network. More discussions on coding required
RRT in the Paediatric population: a separate work stream to run alongside adult work

3. Remaining issues for our service
Year before dialysis
Supportive and Palliative kidney care
Proposal
Need to define currencies and costing methodologies
Similar approach to RRT using a number of committed centres with expertise
Your input, help and suggestions required

4. Opportunities for improvement?
Darzi Next Steps Review –
Systems and Incentives Pricing Workstream
‘Systems and Incentives’ is one of the workstreams in the Darzi Review: the DH PbR team leads on “pricing”
Nee HaOW
I’m afraid that’s the limit of my Mandarin
Two presentations. 4 4

5. Key questions
Building on ‘Options for the Future of PbR’, how should PbR develop in order to support desired outcomes and models of care?
What would more effective payment mechanisms look like?

6. Issues for renal medicine
What are the perverse incentives preventing delivery of high quality of care pathways across primary, secondary and tertiary care as envisaged by Darzi
What would you do to fix it? 6 6

7. Incentives
Should pricing be based on therapy costs for individual treatments or a ‘patient pathway’?
How would you build in incentives to ensure that patients receive the most appropriate high quality therapy based on informed choice?