Payment by results

[LizK]

The brave new NHS with its new way of commissioning services is failing children with chronic conditions like autism

 

Previously person was referred to paed/CAMHS/OT etc and often kept on even if just for yearly review. Now the way Chidlren's Sefvices are commissioned means that had radically altered. Services are paid by episode so each new referral generates income. Therefore one child taking up 10 appointments generates less income that three children having three appointments. Short term acute work is more luctrative than ongoing chronic cases. Health services are being put under pressure to churn patients in and out of the system as quickly as possible to have a high turnover. It is children like ours with ongoing lifelong conditions that will suffer. For example a paediatrician or child psychiatrist may diagnose a child with ASD but will then have to discharge them soon after. I'm hearing more often of parents getting two or three appointments with a medic getting diagnosis then being booted out of the system with the 'you can be referred back if you need' ringing in their ears. Our sons' OT is desperately trying to discharge him despite her admitting that ideally he would be kept under anual review. That of course generates less money than him being rereffered back but a referral will mean a 4mth wait to be seen-and all the rest. It is not her fault or the clinicians fault as such these edicts are coming from the managers and those who organise and commission services and I know the OT would get into trouble from her seniors if she kept my son on against departmental policy. Every Child Matters, Every Disabled Child Matters and whatever other lip service edicts that have been delivered are worthless in the current climate where ���������s count for more than what si actually in the child's and family's best interest

 

Lx

[smiley]

I've had a lot of parents telling me they've been signed off from various NHS services............. now i know why!