I wouldn't agree that all private initiatives go for dragging in as much income as possible. My commercial life was in an organisation that was immensely succesful with a policy of "demand management" and reducing investigations. Think the mark of a "good" PFI will be how they will facilitate demand management
Of course, where is the difference between PFI trying to maximise income and NHS organisations trying to secure income by ever expanding capacity, and hoping to get tariff from PCT. It's interesting to see how many Trusts have plans to solve their finanicial dificulties by "growth"
On Order Comms - Indigo allows us to pin individual tests down to requestor
dj
Dr David James
Consultant Chemical Pathologist
Department of Pathology
Taunton & Somerset NHS Trust
Taunton
TA1 5DA
Tel: 01823 34 22 72
Cell: 077 6688 0838
Fax: 01823 27 10 23
>>> "O'Connor John (Royal Devon and Exeter Foundation Trust)" <[log in to unmask]> 06/09/2011 9:49 AM >>>
I agree the accounting mechanisms should be flexible enough to allow
charging the requestors. Service line reporting to directorates /
specialities should provide sufficient granularity to allow "name and
shame" reviews to take place.
We were heading in that direction here, but then we introduced "order
communications" (System C Medway) which audits activity on the basis of
"clinical episodes". Trouble is the system is not flexible enough to
ascribe activity outside of the originating "episode", recording all "in
patient" activity against that consultant and speciality from that point
on until discharge.
So it's a case of "caveat emptor" if you're procuring an OCS system.
The other issue is if you intend going down a PFI route. I would imagine
a pre-requisite to that is a robust and reliable accounting system
within the trust to performance manages a PFI provider. Tim's comment
"can ignore all
of our exhortations to thrift." Would certainly be the case in a PFI
scenario, after all why would a provider want you to scale back on using
its services?.
The danger then is the Q dropping off QIPP and you end up just doing the
wrong thing cheaper.
Happy days
BW John
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Jonathan Kay
Sent: 06 September 2011 09:23
To: [log in to unmask]
Subject: Clinical Budgetting
But shouldn't nearly all of Laboratory Medicine expenditure be charged
back to requesters?
Does anyone have any good experience of this?
In Oxford we've twice introduced it and twice watched it fade away. It's
never run long or consistently enough to affect requesting behaviour.
It amazes me that studying and implementing this isn't part of NHS
"Modernisation" initiatives. No-one should be allowed to a meeting on
the subject without reading the first few chapter of Samuelson.
Any papers on Clinical Budgetting worth reading since Trevor Gray's
analysis from Sheffield?
Jonathan
On 6 Sep 2011, at 09:12, Reynolds Tim wrote:
> I have been arguing for quite some time that internally we should not
> have a budget for hospital requests or phlebotomy and that it should
be
> devolved back to requestors. This has not been accepted by those who
> would be budget holders because they would have to take the pain of
> controlling their requesting, as opposed to now when they can ignore
all
> of our exhortations to thrift.
>
>
>
>
> Dear ACB mailbase users
> In the current difficult financial climate, can I dare to ask if any
> Biochemistry/combined sciences department has managed to defer part or
> all of their budget to different directorates. If you have done so,
can
> I share with you your experience especially if by doing that the
> financial accountability would be deferred to the requestor.
>
> Thank you
> Best Regards,
> Soha
>
> Dr Soha Zouwail
> Consultant Chemical pathology
> Department of Medical Biochemistry and Immunology
> University Hospital of Wales
> Heath Park, Cardiff CF14 4XW
>
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical community
working in clinical biochemistry.
Please note, archived messages are public and can be viewed via the
internet. Views expressed are those of the individual and they are
responsible for all message content.
ACB Web Site
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical community working in clinical biochemistry.
Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
This message may contain confidential and privileged information.
If you are not the intended recipient please accept our apologies.
Please do not disclose copy or distribute information in this e-mail or take any action in reliance on its contents: to do so is strictly prohibited and may be unlawful.
Please inform us that this message has gone astray before deleting it.
Thank you for your co-operation.
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical community working in clinical biochemistry.
Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|