Thanks Adam

Would your good self or anyone else have a copy of the letter sent to Chief Execs from NHS improvement?

Many thanks

John

 

 

The day before this report was published, all Chief Executives received a letter from NHS Improvement giving them one month to produce plans for consolidating back-office and pathology services:

 

http://www.hsj.co.uk/topics/finance-and-efficiency/exclusive-paybills-and-planned-care-targeted-in-huge-savings-drive/7005999.article?WT.mc_id=Newsfeed&WT.tsrc=t.co

 

http://www.nationalhealthexecutive.com/News/lord-carter-savings-drive-must-pursue-value-with-same-rigour-as-quality-

 

Adam

 

 

 

 

This is a sensible review of Pathology services that looks at the role of Pathology in the context of the patient pathway rather than some reports that see Pathology as an isolated cost centre divorced from the patient pathway.  I would agree with John that it is a very good read and should be copied up the management chain.

 

One quote shines out:

 

“Now is a good time for boards to review their approach to pathology as one of the key diagnostic disciplines. Strategies that go well beyond delivering efficiency savings are essential if providers are to deliver the full value of what pathology can offer to service transformation”.

 

The age of silo cost cutting for Pathology should be over and the age of the strategic use of Pathology (even if pathology costs go up) has arrived.

 

Martin

 

 

Some other quotes that may be of interest:

 

From the Report of the Review of NHS Pathology Services in England (2006) :

•          “..total spend per capita on in vitro diagnostics in the UK is half (10.4 Euros) that of equivalent countries in Europe- Germany (21.9), France (24.2), Italy (24.8)”

•          “As a proportion of total health expenditure, spend on in-vitro diagnostics in the UK is half that of Italy, and in Europe only Denmark is below the UK level.”

•          “Data from the USA suggests that the spend on diagnostics is at least 4 times that of the UK.”

•          “These findings suggest that pathology service providers in England are operating both safely and efficiently.”

 

From the Report of the Second Phase of the Review of NHS Pathology Services in England (2008) :

·         “Based on these models, we estimate that potential savings of between 10 and 20 percent could be achieved.”

·         The cost of a Clinical Biochemistry test has decreased by 26% since 2007

 

From the Operational productivity and performance in English NHS Hospitals: Unwarranted variations (2016):

·         “Pathology providers are considered productive if the cost is less than 1.6% of operating expenditure”

·         The 1.6% cost of pathology is based on costs which excludes all medical salaries, all blood products, 50% of Direct Access costs, and more; yet these exclusions are not transparent.

·         When it comes to “costs” the last 2 reports adopt a “chase to the median” where the median is an internal system target with no external systems.  Chasing the median in a closed system is a race to the bottom.

 

In my opinion Pathology in the UK has reduced its costs.  The next step for pathology is to “go well beyond delivering efficiency savings” and to “deliver the full value of what pathology can offer to service transformation”.  If Pathology succumbs to further cost reduction then it risks creating a crisis in governance, staffing, sustainability, specialist services and not be in a position to contribute to service transformation. 

 

 

Can I draw list members attention to the “hot off the press” Nuffield report:

“The future of Pathology Services”

I would highly recommend as a very good read.

http://www.nuffieldtrust.org.uk/publications/future-pathology-services

 

BW John

 

Dr John O’Connor

Consultant Clinical Scientist

Lead Scientist RDE

 

Website: www.exeterlaboratory.com

 

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