Our Trust works a system where every Clinical Service Unit must break
even.
Historically the ED was underfunded (80% of tariff) and so initially our
funding increased whilst other areas saw dramatic spending cuts. The
ultimate plan is to 'encourage' every CSU to become an almost
independent business which, after a top slice for Trust wide expenses,
is free to spend any money it earns.
We currently run below tariff (95%) and hit the four hour standard
(usually) but with 4 fewer consultants, 2 fewer middle grades, 2 fewer
SHOs and about 8 fewer ENPs than recommended by CEM. We are also
understaffed from a nursing point of view, but that is harder to
quantify as there are no official figures for numbers and skill mix, as
far as I am aware, in the way there is for docs and ENPs. I reckon we
are at least 2-3 nurses short a shift.
So, is it possible, probably. Is it advisable, no!
Simon
P.S. We are soon being funded for two more consultants and some nurses
outside of this by the PCT but on the understanding that we improve
further on the 4 hour standard!
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Dunn Matthew Dr. (RJC)
A & E - SwarkHosp-TR
Sent: 18 May 2009 09:04
To: [log in to unmask]
Subject: Finance
There is an ill guarded secret that we are applying to become a
Foundation Trust. Part of what we'll be doing is trying to square the
circle between income and expenditure on each department. What I'm
interested in is whether anyone has managed to keep their department's
expenditure less than the income (particularly once you add in the cost
of the buildings, the costs of investigations and a contribution to the
general running of the hospital and to the free phone number in case
anyone wants to find out more about our application). I seem to recall
Henry Guly wrote an article in EMJ a couple of years back saying that it
wasn't possible, but I'd assume (possibly naively) that the PbR figures
were based on costs of an average or typical department. Anyone actually
managing to do it? And if so how? (An idea of income, spread of patients
on the different payment types, staffing etc.)
Matt Dunn
Did you know South Warwickshire General Hospitals NHS Trust is applying
to become an NHS Foundation Trust? You can find out more about our
application and/or apply for Membership at
http://www.warwickhospital.nhs.uk/foundationtrust/default.aspx or by
calling our Foundation Trust Office on free phone 0800 085 2471.
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