Simply…..

How much does the NHS charge

Gloria Middleton

Westbourne Medical Group

Housekeeping

Fire Alarms

Toilets

Fire Escapes

Disabilities

Why you have been invited

How much of our budget

goes to the Hospital ?

1. Commissioning Groups’s will be in place very soon

2. GP Practices WILL be responsible for ensuring they manage the budgets

3. Patients should be aware of how much treatment costs in the NHS

4. Patients should be aware of how we can work together to ensure we all as patients receive the best care with the best outcomes and what we can do by working together

5. To be more streetwise when we ourselves or a family member goes to hospital whether it be an out patient appointment or as an inpatient

6. Have the knowledge so enable us to manage ourselves better if not for now but certainly for in the future

Lets have a look

at the pathway of care

Payment process

Surgery PCT

Hospital

Patient from surgery goes to hospital

While in hospital the patient has an operation

After discharge costs are calculated using PBR – Statement is sent to PCT for payment.

Soon it will be the CCG’s

Cost is taken out of Surgery

Practice’s Budget

Accident & Emergency .. The true cost

•Minor CostMinor Cost £59 £59

•Standard Cost Standard Cost £75£75

•High CostHigh Cost £117£117

How do we know

how much everything costs ?

Business Information Reporting Tool

To us known as …….BIRT

Some real examples

•Male patient aged 53Male patient aged 53

•Attends A&E and is admitted as an emergency patientAttends A&E and is admitted as an emergency patient

•Stays overnightStays overnight

•The following Diagnoses recorded:The following Diagnoses recorded:

•J440 Chronic obstruct pulmonary dis with acute lower resp infec J440 Chronic obstruct pulmonary dis with acute lower resp infec

•J189 Pneumonia, unspecified J189 Pneumonia, unspecified

•J459 Asthma, unspecified J459 Asthma, unspecified

•Z720 Tobacco useZ720 Tobacco use

•Grouper allocated HRG codeGrouper allocated HRG code

D39 - Chronic Obstructive Pulmonary Disease or Bronchitis w ccD39 - Chronic Obstructive Pulmonary Disease or Bronchitis w cc

How much do you think that cost? £1459

Example 2

•Female patient admitted for planned surgeryFemale patient admitted for planned surgery

•Stays for 4 nightsStays for 4 nights

•The following procedure information was recorded:The following procedure information was recorded:

W371 Primary total prosthetic replacement hip joint using cementW371 Primary total prosthetic replacement hip joint using cement

Z943 Left sided operationZ943 Left sided operation

•Grouper allocated HRG code:Grouper allocated HRG code:

H80 - Primary Hip Replacement CementedH80 - Primary Hip Replacement Cemented

How much do you think that cost? £5,220

9.4.2010 – 6.3.2011 Cost £33,321 25 contacts with hospital

10.4.2010 – 11.3.2011 £24,543 9 Contacts (Hip replacement)

“The Doctors are just getting a second opinion on the financial aspects of your treatment Mr Brown..”

Prescribing

Some practice’s are over budget

Not only because of the Clinicians prescribe

BUT

We have a lot of waste in the system.

Prescribing costs March 2011

Actual Budget Variance

• Dr 1 £2,289,166.00 £2,151,645.00 £137,521.00 6.39%

• Dr 2 £1,103,556.00 £1,165,530.00 £61,974.00 5.32%

• Dr 3 £1,709,171.00 £1,571,881.00 £137,290.00 8.73%

• Dr 4 £1,065,924.00 £1,259,478.00 £193,554.00 15.37%

• Dr 5 £1,243,250.00 £1,149,454.00 £93,796.00 8.16%

If a patient is sick they should be in hospital….. If a patient is sick they should be in hospital…..

Without a doubtWithout a doubt

If a patient is well enough to be cared for in another If a patient is well enough to be cared for in another way and they are blocking a sick patient going into way and they are blocking a sick patient going into

hospital then we should be able to do something about hospital then we should be able to do something about it….it….

One thing we do know is…One thing we do know is…

What can you do to help

If you are seen by a Nurse instead of the Consultant question this

Why: Because we are charged for you seeing a Consultant

If you or someone you know has been in hospital and nothing has been done for 2 days question this

Why: It could be that they are waiting for a Social Worker…

NOT ACCEPTABLE

Notify your GP practice if you are admitted as an emergency more than 3 times for the same problem and no action taken

Why: Because every time you are admitted a new payment starts

If you need to go to Minor Injuries or Accident & Emergency ask yourself ..

Do you have a minor injury, have you had an accident..

Is it an Emergency ???

Why: Because 10 people not attending A&E could pay for a hip operation

In General Practice our message is

We want you to get the best possible care

We only want to pay for the service you receive

Having our Patients understand the NHS

Even though every day we hear ‘we have paid our contributions’

We all need to work together to keep the NHS in the NHS

WHAT NEXT ?

Holding an event to inform all patients across Coalfields area

Invite other Organisations to have a stand

Age Concern

Alzheimer’s Association

Carer’s Association

Gentoo

And any others you decide to have

Funding for Event

Apply to Directors Den

Who would do it?

Something for you to think about !

So how much did you cost the NHS in 2010

/11 ?

Why not ask your Practice Manager for a breakdown

Of your hospital costs !