Payment by Results (PbR) was introduced into the NHS with the aim of improving efficiency and increasing  value for money. The approach uses a national tariff of agreed fixed prices reflecting average prices for procedures.

In this article, the authors argue that given that outcome focused approaches to payment by results will be incrementally introduced into mental health services from 2012, it should be possible to roll this out to learning disability services as well, even though they are currently excluded,.

The authors argue that this approach could be the key commissioning and designing personalised pathways of care for people with learning disabilities..

The authors have produced 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 and they present a  case example to illustrate how these components can be used to develop a care pathway to provide personalised, needs led services.

Payment by Results in intellectual disability services – a vehicle for personalising healthcare, Roy A & Bhaumik S, in Advances in Mental Health and Intellectual Disabilities, 6 2, 89 – 98