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The BBC are reporting: NHS funding 'manipulation threat'
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Hospitals could manipulate a new system of NHS funding to get more money than they should, local NHS officials fear.
Payment by results is currently being introduced, whereby hospitals are paid per patient treated rather than in lump sums based on past activity.
The NHS Alliance poll of 109 officials found 83% thought hospitals would admit people unnecessarily and keep them in too long to earn funds.
The government said rewards for other NHS services were available too.
Payment by results is already being used for elective operations, but from April it will be introduced for A&E, emergency surgery and outpatient care. The rest of the NHS will follow in 2009.
Some 93% of survey respondents, who included primary care trust officials and GP practice managers, said the current structure needed amending.
And the report by the NHS Alliance, which represents primary care professionals, said the suggestion that hospitals may be using the system to get extra cash was particularly worrying.
It said that it meant less money would be available for the push to move more care from hospitals into the community as set out by a government white paper last month.
The NHS Alliance said a comprehensive set of rules needed to be drawn up to prevent such abuse of the system.
NHS Alliance chief executive Michael Sobanja said: "There are some fundamental problems that cannot be addressed by piecemeal solutions. That would lead to more but different problems and perverse incentives.
"Payment by results is a sensible idea that is in danger of going wrong in implementation.
"If NHS reforms are to deliver real improvements, we must establish structures that reward partnership rather than the worse excesses of competition - and that focus on patient rather than the convenience of those running the system."
The Department of Health dismissed the claims, pointing out that under payment by results the money available for hospital care was balanced by rewards available for providing services in the community.
"It provides incentives for the development of alternative primary and community services where these are more clinically effective and cost effective than hospitalisation."
And Dr Gill Morgan, chief executive of the NHS Confederation, which represents NHS trusts, said the survey's findings painted a "simplistic picture".
"To focus on one element of this complex reform programme risks missing the inter-connection of all of the strands of the payment by results policy.
Many problems were "a feature of transition rather than long-term problems and it is easy to exaggerate their importance," said Dr Morgan.
"However, some external audit, combined with clear and enforceable rules of behaviour for NHS organisations, will be required."
Potential for manipulation of NHS funding
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