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Rafael Goriwoda & Jake Gommon NHS England present on the National Policy on Outcomes and Best Practice Tariff

Rafael Goriwoda Economist Patients and Information Analytical & Jake Gommon Economic Adviser NHS England Pricing Team NHS England present on the National Policy on Outcomes and Best Practice Tariff. 

Jake Gommon and Rafael Goriwoda work as economic advisers in different parts of NHS England.  Jake works in NHS England’s recently established Pricing Team which has joint responsibility for the production of the National Tariff, while Rafael works in the Patient & Information Analytical Team, where he leads on analysis of Patient Reported Outcome Measures.  Both Jake and Rafael hold an MSc in Economic Management and Policy (Strathclyde) and Economics (Sussex) respectively and joined the Department of Health in 2009 before moving on secondment to NHS England.

Their presentation demonstrates how their respective teams are working collaboratively to understand and promote better patient outcomes.

Since April 2014, NHS England has held joint responsibility with Monitor for producing the National Tariff. This specifies the rules and rate of financial reimbursement for publically funded hospital activity in England. Prior to this, the National Tariff had been operated by the Department of Health under the system known as Payment by Results (PbR). One feature of the National Tariff is the so called ‘best practice’ tariffs that provide financial incentives for the delivery of high quality care. The concept of best practice tariffs was a recommendation of the Darzi Review (2008) and was first introduced to the National Tariff in 2010/11.

The presentation discusses the recent addition of a best practice tariff for primary hip and knee replacement in the 2014/15 National Tariff, conditional on patients’ own reported outcomes (PROMs) following the intervention.  The use of PROMs ensures that patient’s outcomes are at the core of the reimbursement system.

Jake and Rafael diccused  a number of key aspects including: the design of the incentive model; choice of appropriate metrics; methods for outlier identification; strategies to mitigate any unintended consequences; and how PROMs data can be used not only to identify good or bad outcomes, but to understand them and help providers to address them.

More information on the Best Practice Tariff can be found in the National Tariff guidance:

More information on NHS England’s work on PROMs can be found at:

Scroll down for full presentation 

Events of interest: 

Patient Experience Insight: Demonstrating Responsiveness to Feedback
Wednesday 4 February 2015, Birmingham

A Practical Guide to Improving Outpatient Services
Thursday 12 February 2015, London

Setting Up and Running Virtual Clinics
Monday 20 April 2015, London

Download: Jake Gommon & Rafael Goriwoda Full Presentation

3 December 2014


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