Great question.
1 If you and your Director of Finance don't have an agreed definition of success I don't think you'll achieve it. After you have a common definition of success you can see whether all the players have common incentives. (That's the whole subject of general management solved.)
2 Would the relevant clinicians agree with your modelling exercise?
3 Does the position look any clearer if you draw out options for future years rather than comparing the future with past years? Historical-based budgetting often gets in the way of improved processes, and improved management of processes. (This isn't only a problem of the NHS.)
4 "Savings" is an ambiguous term. Wikipedia has "Saving is income not spent, or deferred consumption.". Note that it isn't defined as "Spending less than last year".
5 How many UK departments of Laboratory Medicine prepare Income and Expenditure accounts?
Why are the so few responses to this... many of us must recognise at least parts of this problem.
Good luck
Jonathan
PS: I guess it's plasma urea and at least one thyroid-related assay.
On 6 Jun 2011, at 17:46, Gary Mascall wrote:
> Looking at the following scenario, how would you apportion the saving?
>
> Laboratory and GP's identify 2 high volume tests with limited clinical value for majority of primary care patients.
> Laboratory does a modelling exercise, and identifies only around 20% of tests are required, and if the un-needed 80% were stopped, would save the laboratory in the region of £50,000 on reagents. Hence a true Pathology saving.
>
> However, income from these tests would have brought in £500,000 in payments from primary care.
>
> So, an apparent Pathology saving would end up reducing the Parent Organisation's income by £450,000. Pathology not now such a "good boy", but told now to make an additional £450,000 CIP saving to make up the shortfall in Trust income.
>
> Or, should Pathology and Primary Care be congratulated for jointly coming up with a strategy for saving £550,000, which if the model was followed across UK, could release at least £10,000,000 into the health economy either as a saving, or to be redistributed for other worthwhile medical/surgical interventions?
>
> Nowhere in any of the current round of QIPP have I seen anything which relates to this scenario, it is all about withdrawing costs out of Pathology, and would be interested in other people's thoughts.
>
> Gary Mascall
> Consultant in Clinical Biochemistry
> worcestershire Acute Hospitals NHS Trust.
>
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