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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