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Guidance, case studies and key principles to support designing and implementing new payment mechanisms, as set out in the 10 Year Health Plan, have been presented by NHS Confederation.

Key points

  • Current financial flows are a barrier to delivering NHS reform and financial sustainability. The 10 Year Health Plan has set out the need for payment reform and the requirement for integrated care boards, as strategic commissioners, to design and implement innovative payments mechanisms.

  • While the vision outlined in the 10 Year Health Plan is the right one, implementing these new financial flows will challenge long-established principles and ways of working in NHS finance, requiring a shift in mindset across the whole sector.

  • NHS leaders previously identified outcomes-based payments for patient pathways or populations as a key area for local experimentation to reform financial flows. The NHS Confederation has been working with a small group of integrated care systems (ICSs) to develop their own local approaches to outcomes-based payments.

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Date: 12 October

Posted in News on Oct 12, 2025

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