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ACB-CLIN-CHEM-GEN  September 2011

ACB-CLIN-CHEM-GEN September 2011

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Subject:

Re: Clinical Budgetting

From:

"Auld, Peter" <[log in to unmask]>

Reply-To:

Auld, Peter

Date:

Tue, 6 Sep 2011 10:28:27 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (323 lines)

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
>>>
>>
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> Mae'r neges hon yn gyfrinachol.
> Os nad chi yw'r derbynnydd y bwriedid y neges
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