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Good to see this is back on the agenda, I have long been a fan, in theory anyway, since Trevor's Gray's paper some years ago. It seems to me this approach goes a long way to consolidating the position of the clinical laboratory as integral to clinical processes rather than being portrayed as a constant and uncontrollable financial drain as some would have it. Peter -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jean Wardell Sent: 06 September 2011 10:03 To: [log in to unmask] Subject: Re: Clinical Budgetting We cross charge here on a full cost basis to both internal requestors and primary care. We hold a budget, cross charge at full cost via service line reporting and then recover 'volume funding' for any over performance on agreements into the direct budget the following year so that we are funded at out turn activity. All tests are individually costed and test costs reviewed on an annual basis. This has been in place a couple of years and is constantly being refined but so far appears to work well. Jean -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Webster Craig Sent: 06 September 2011 09:41 To: [log in to unmask] Subject: Re: Clinical Budgetting Yes, this is done on a per patient, per set basis. We still have a number of unknown locations/consultants and spend a reasonable amount of time trying to track this, if we can't the cost of the unknowns is spread amongst all requestors. Cheers Craig On 6 Sep 2011, at 09:34, Soha Zouwail (Cardiff and Vale UHB - Medical Biochemistry) wrote: > > Craig > I would assume that you have a patient level costing system running efficiently and electronic requesting to be able to achieve this step. We are still developing our patient level costing and some time away from the electronic requesting. Now quite a percentage of our request forms do not have consultant code or location to defer the cost to a specific directorate. > BW > Soha > > Dr Soha Zouwail > Consultant Chemical pathology > Department of Medical Biochemistry and Immunology University Hospital > of Wales Heath Park, Cardiff CF14 4XW > > -----Original Message----- > From: Clinical biochemistry discussion list > [mailto:[log in to unmask]] On Behalf Of Webster Craig > Sent: 06 September 2011 09:24 > To: [log in to unmask] > Subject: Re: Clinical Budgetting > > We do it here, although not at full cost. Its charged back at reagents only! It still makes a massive difference though and now we have lots of requests to look at demand management, building protocols of investigation etc. > > The first example of this was in A&E and this reduced the amount of > requests by around 30% > > Cheers > Craig > On 6 Sep 2011, at 09:23, Jonathan Kay wrote: > >> >> 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. 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