E-mails From Marie Grant Chief Nurse & Ian Harris Finance Directorate
From:
Ian Harris
Sent:
15 July 2002 16:18
To:
Marie Grant
Cc:
Kevin Harbottle; Ian Hamilton; Ian Perkin
Subject:
RE: Variable Tariff
Marie,
Thank you very much for your comments and
queries.
The bulk of the variable tariffs are made up
of Drugs, Medical and Surgical
Supplies and Equipment, Provisions, Appliances, Blood and Blood products.
Since the publication of the first draft,
the Projects Team has continued to examine areas on inconsistency. This
investigation revealed that some of the inpatient variable tariffs (especially
geriatrics but including cardiology and orthopaedics) were understated. This has
now been corrected.
With regard to your general comments:
the cost differences on the various critical
care areas arises mainly due to differences in the costs directly attributable
to those areas however following on from your comment I am currently
investigating the variable tariff for Neuro intensive care which is clearly very
different to General and Cardiac ITUs.
it would be helpful if you could elaborate
further on orthopaedics in order to concentrate our efforts on those elements
which are of particular concern to you.
OP costs were incorrect in terms of the
relative costs within each specialty. This has been addressed in the work that
we have been doing post publication of the first draft. In general though,
outpatient variable costs will always be quite low due the fact that out patient
clinics are labour intensive rather than materials intensive.
Cardiac non elective work is generally
cheaper, in variable cost terms than cardiac elective work. This is because
patients in this category consume few catheter lab and pacing clinic consumables
than elective cardiac patients. Generally, non elective cardiology work is more
expensive in full cost terms because of longer lengths of stay and thus greater
recovery of fixed and semi fixed costs.
I can confirm (having investigated following
your query) that the variable tariff for CCU is incorrect. This is because the
drugs cost for CCU had not been charged to CCU. This has been corrected and the
variable cost will be calculated as approximately £30 per day.
Regards
Ian
-----Original Message-----
From:
Marie
Grant
Sent:
12
July 2002 18:19
To:
Ian
Harris
Cc:
Kevin
Harbottle; Ian Hamilton
Subject:
Variable
Tariff
Ian
.I'm not sure whether I fully understand the
above. If I'm reading them right I can now understand why our financial position
is what it is as we are not getting the income for delivering the complex case
mix that we perform. The variable cost in my view are far to low.
What happens when we over perform to deliver
targets do we not incur costs over and above consumables?
A couple of general comments
Why is there such a variation in the cost for the
different ICU?
Orthopaedics looks incorrect
O/p costs look incorrect
Cardiac Non elective seems cheaper that the
elective why?
CCU must
be incorrect £11.42 average cost?
From a nursing perspective all of these look very
low in cost in comparison to what in reality would be used.
Do we need to review from a clinical point of
view as probably from a Finance point they are correct technically.
It just seems that we are selling ourselves down
the river.
Hope these comments are of use
Marie