Having not read any of this in detail yet – what does this mean for NHS labs which find themselves in a proposed network with a big private organisation? Looking particularly at London 2 – is the NHS recommending that the two public labs get taken over by the (semi) private one? (Disclaimer: I work for the private one!) Also intrigued about what happens to existing networks – Bedford is a viapath lab, but has not been included in the main viapath network – is the recommendation for existing links to be discarded or are these purely recommendations and can be merrily ignored where they don’t suit any of the parties involved?

 

I imagine some of these links could be a major headache – having gone (and still going) through the merger of a number of sizeable labs, to make 29 really effective and efficient networks of labs will take a huge amount of investment from NHS England.

 

Simon

 

Dear Collective

For me, the problem is the accuracy of the data used to make the recommendations in the report.

The data collection template issued to trusts to assess activity has been open to misinterpretation.

A very simple quality control check would be to look at the tests declared (from the NHSIA documents) and very simply use the population served as the denominator in order to work out the number of tests done per head of population.

I have done this for our proposed network in the SW

If you look at the populations covered by the individual trusts in our proposed network from

Here https://www.newdevonccg.nhs.uk/about-us-100131

And also here

https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/clinicalcommissioninggroupmidyearpopulationestimates

You can work out  of tests per head of population,  this varies by 100% in our  geographical region?

 

Trust	Population	Tests declared	tests per patient
Plymouth (hub)	370800	7449690	20.1
Exeter	378600	6403656	16.1
North Devon	157700	5353434	34.0
Torbay	278566	6403656	23.0
Cornwall	551000	not declared

 

This is crucial to the selection of hubs based on their selection (more or less, but size mattered also) on being able to process a test based on the lowest unit cost.

 

The whole point of the recent Carter report is to reduce variation, which I absolutely applaud. So just having hubs and spokes would not tackle this disparity. That of course is if the data returns are true and consistent. Alternatively, if the above is telling us that the bean counting exercise has been subject to misinterpretation then surely someone at the NHSIA needs to undertake a reality check on the data submitted given the predicted savings that are going to fall out of the new network topographies.

It would be quite interesting for the same exercise to be applied to all the other 28 proposed networks.

On the other hand I am one of those nearing the end of my NHS career and as Jonathan has alluded previously, plenty of consultancy to drop out of this initiative  so perhaps I shouldn’t rock the boat too much!!

 

 

BW John

 

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