We have clinical budgeting here in Hull (although we do not include staffing
unfortunately) for about the last decade. It has made not one iota of a
difference to the requesting pattern of clinicians since it is not their
money. In fact, in one regard it has had a detrimental effect. When we
wished to move over to discretionery requesting of U&E (ours includes urea),
Bone and LFT biochemistry rather than a 'profile' of all 3 the directorates
assumed they would only pay a third of the cost for each. When we told them
they would be saving the price of a stamp they didn't want to know, so we
largely continue with profiles.
At year end the directorates and PCTs plead bankruptcy anyway.
Eric
----- Original Message -----
From: Jonathan Kay <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, July 26, 2002 2:47 PM
Subject: Clinical budgeting... was Re: Creatinine and urea etc.... should be
""Pathology" "Modernisation""
> ...and that's why we should move to "Clinical Budgeting": see previous
> postings about Trevor Gray's article...
>
> ...is anyone pursuing this actively in "Pathology" Modernisation"?
>
> Dr Jonathan Kay
>
>
> On Friday, July 26, 2002, at 02:37 , Martin Brian (RH8) R D and Exeter
> HC Tr wrote:
>
> > Interesting comments from Trevor regarding Jonathan's 'last sentence'.
> > We
> > have for some time been battling with a local consultant regarding his
> > almost routine requests for alpha-1 antitrypsin, caeruloplasmin and
> > copper
> > assays in patients with 'Abnormal Liver function tests'. The
> > abnormalities
> > are usually fairly minor increases in liver enzymes. The aforementioned
> > tests are sent to other laboratories by us and therefore are relatively
> > expensive. His argument is that by doing all these tests at one hit,
> > he is
> > reducing the number of clinic visits required by his patients, i.e. one
> > clinic visit saved is a lot more cost-effective for the Trust as a
> > whole,
> > compared to the relatively minor expense to the Lab. All very well, but
> > none of the savings seem to come the laboratory's way!
> >
> > Brian Martin
>
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