1

BEST PRACTICE TARIFF

FOR HIP FRACTURE

LOUISE BRENT IRISH HIP FRACTURE DATABASE AND MAJOR TRAUMA AUDIT MANAGER

GENERAL SECRETARY FFN

CHAIR ICON

@louisebrent28

Lord Darzi, an eminent surgeon at Imperial College London, a commitment

was made to ‘Best Practice Tariffs’. This is a method of reimbursing providers

based not on average cost, but by the cost of best practice. In the review’s

words: ‘To support local efforts to address

unexplained variation in quality and

universalise best practice, we will start to

pay prices that reflect the cost of best

practice rather than average cost. This will be

enabled through the Best Practice Tariffs programme, which we will

introduce where the evidence of what is best practice is clear and

compelling. We will start in 2010/11 with four high-volume areas where there

is significant unexplained variation in practice: cataracts, fractured neck of

femur, cholecystectomy, and stroke care. We will discuss this proposal with

clinicians and give further information on these areas later this year so that

providers can plan in advance of tariff changes. The Best Practice Tariffs

programme will be rigorously evaluated, not least to ensure that it is working

for all the partners involved in the delivery of care, and if successful,

expanded in future years.’

Best practice tariff

BPT price (tariff)- The price paid for activity where the

requirement(s) of the BPT are achieved. This will

normally be higher than the conventional price.

BPT Ireland

Meet all 8 standards = €1000 extra per case

Buy in

Key enabler

What does BPT achieve?

Has a financial incentive improved care?

Coverage

Governance committees

0

2

4

6

8

10

12

14

16

18

Q1 2018 Q2 2018 Q3 2018 Q4 2018 Q1 2019 Q2 2019 Q3 2019

No

. o

f H

osp

ita

ls

Quarter

NO. OF HOPSITALS

No. of hopsitals

IHFS

Payments per hospital 2018

Proportion of patients meeting BPT 2018

SUSTAINED IMPROVEMENT

Quarterly payments

34,000

71,000

90,00083,000

98,000

140,000

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

Q1 2018 Q2 2018 Q3 2018 Q4 2018 Q1 2019 Q2 2019

Tota

l A

mo

un

t €

Quarter

BPT Payments

3%

7%

9%8%

11%

17%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

% Meeting BPT

Q1 2018 Q2 2018 Q3 2018 Q4 2018 Q1 2019 Q2 2019

% achieving BPT per quarter

LOS

• Equipmenti. bladder scanners

ii. Lo-Lo beds

iii. hoists

iv. under-body warming blanket for theatre

v. Portable ultrasound scanners

vi. sub-epidermal moisture scanners (pressure ulcer scanners)

vii. Patient comfort i.e better seating

viii. equipment for dementia-friendly ward

Education/ Researchi. Conferences, courses

ii. QI projects

iii. Research

What the money is being spent on

NOCA/ HPO

analyse data

Quarterly report issued to hospitals/ hospital groups by

NOCA

Data entered by hospitals for each reporting quarter

• Measurement (IHFD)

• Feedback

• QI

• Measurement (IHFD)

• Feedback

• QI

• Measurement (IHFD)

• Feedback

• QI

Key to success

The most important people

Any questions?

Thank you for listening