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Payment by Results in intellectual disability services – a vehicle for personalising healthcare
- Authors:
- ROY Ashok, BHAUMIK Sabyasachi
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(2), 2012, pp.89-98.
- Publisher:
- Emerald
Payment by Results (PbR) aims to provide a transparent rule-based system to pay providers for interventions based on health need. An outcome focussed version of PbR will be implemented nationally from 2012 in an incremental manner in mental health services for adults and older people. Though intellectual disability services are currently excluded, this article proposes that the needs led principles underlying PbR would improve the quality and efficiency of specialist intellectual disability services. The aim of this paper is to review the components of the PbR process and to examine possible benefits for intellectual disability health services. Health needs are scoped, and care pathways are defined as primarily consisting of ‘needs’, ‘interventions’ and ‘outcomes’. The mandated cluster groups to be used for PbR in adult mental health and older people's services are extended to cover the non-overlapping needs of people with intellectual disability to provide an integrated framework of health needs usually met by specialist services. A framework of interventions is suggested and components of ‘assessment’ and ‘therapeutic’ activities are outlined. An outcome framework is described. A case example illustrates the application of these components to design a care pathway to provide a personalised, needs-led service.