The principles underlying a Payment by Results (PBR) approach to reimbursing mental health service providers have been under discussion for many years. They state that the system should improve clarity for service users and carers about what they can expect from services and the outcomes they can achieve, and facilitate an understanding of clinical processes between commissioners and providers, and between clinicians and service managers. PBR for adult mental health services will be introduced in the NHS in 2012/13. While commissioners and providers broadly support this, they have identified significant challenges. An independent readiness review was commissioned by strategic health authority (SHA) mental health leads through the Mental Health Network. Findings revealed that much needs to be done across the system in order to begin using PBR in the 2012/13 introductory year, and to develop the system during that time, and beyond. This Briefing outlines the key findings and recommendations of the readiness review.