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Detailed Calculations Showing How St George's Cheated The Primary Care Trusts.

The correctly calculated variable costs of the various procedures and diagnosis are shown in the Unit Variable Cost column.  The Column marked Revised Variable Cost shows the amount that Barbara Ghodse the Contracts Manager charged the Primary Care Trusts.  The Difference Column is calculated by multliplying the difference between the two costs by the additional activity to arrive at the amount that the Primary Care Trust's were overcharged.

Speciality POD Product Code Product Description  2001/02 Activity  

 Tariff Version 300

 Unit variable cost Revised variable cost Activity variance AV @ old variable AV @ rev. variable Difference
CAR EL CARE15E Elective Percutaneous Transluminal Coronary Angioplasty (PTCA)         327      3,954 2,642 3361 25 66,050 84,025 17,975
CAR EL CARE16E Elective Other Percutaneous Cardiac Procedures         165      3,702 2,489 3147 -8 -19,912 -25,176 -5,264
CAR EL CARE29E Elective Arrhythmia or Conduction Disorders >69 or w cc           46         939 546 798 -38 -20,748 -30,324 -9,576
CAR EL CARE30E Elective Arrhythmia or Conduction Disorders <70 w/o cc           55      1,208 656 1027 -40 -26,240 -41,080 -14,840
CAR NE CARE08N Non-elective Pacemaker Implant except for AMI, Heart Failure or Shock           84      2,609 1,283 2218 67 85,961 148,606 62,645
CAR NE CARE09N Non-elective Cardiac Pacemaker Replacement/Revision           16      1,921 547 1633 6 3,282 9,798 6,516
CAR NE CARE14N Non-elective Cardiac Catheterisation without Complications         388      1,914 686 1627 84 57,624 136,668 79,044
CAR NE CARE15N Non-elective Percutaneous Transluminal Coronary Angioplasty (PTCA)         438      4,361 2,803 3707 204 571,812 756,228 184,416
CAR NE CARE16N Non-elective Other Percutaneous Cardiac Procedures           14      8,223 4,795 6990 5 23,975 34,950 10,975
CAR NE CARE29N Non-elective Arrhythmia or Conduction Disorders >69 or w cc             7      2,346 1,084 1994 12 13,008 23,928 10,920
CAR NE CARE30N Non-elective Arrhythmia or Conduction Disorders <70 w/o cc           22      2,141 1,025 1820 -6 -6,150 -10,920 -4,770
CAR OP CAR4AOP Out-patient Outpatient     18,275           32 7 25 5350 37,450 133,750 96,300
CAR OP CAR4BOP Out-patient Outpatient (Complex)         134           83 18 63 -99 -1,782 -6,237 -4,455
CRS EL CRSE03E Elective Cardiac Valve Procedures         125      7,784 2,301 6227 43 98,943 267,761 168,818
CRS EL CRSE04E Elective Coronary Bypass         463      7,452 2,361 5962 38 89,718 226,556 136,838
CRS NE CRSE03N Non-elective Cardiac Valve Procedures           44      8,190 2,373 6552 0 0 0 0
CRS NE CRSE04N Non-elective Coronary Bypass         177      8,109 2,598 6487 45 116,910 291,915 175,005
Cardiac subtotal             1,089,901 2,000,448 910,547
                       
CMD OP CMD4AOP Out-patient Nurse Led Outpatient      4,091           46 16 35 827 13,232 28,945 15,713
CMD OP CMD4DOP Out-patient Sleep Study Outpatient         399         175 59 131 535 31,565 70,085 38,520
Chest medicine subtotal             44,797 99,030 54,233
                       
DEN DC DENC04D Daycase Mouth or Throat Procedures - Category 1           68         844 101 599 38 3,838 22,762 18,924
DEN DC DENC14D Daycase Mouth or Throat Procedures - Category 2         812         896 107 636 -58 -6,206 -36,888 -30,682
DEN DC DENUNCD Daycase Dental Daycase Uncosted HRGs           71         451 55 320 8 440 2,560 2,120
DEN EL DENC14E Elective Mouth or Throat Procedures - Category 2         114      1,981 260 1407 -39 -10,140 -54,873 -44,733
DEN EL DENC15E Elective ENT Bone Procedures - Category 2             4         844 102 599 7 714 4,193 3,479
DEN EL DENC24E Elective Mouth or Throat Procedures - Category 3           12      2,737 335 1943 4 1,340 7,772 6,432
DEN EL DENC25E Elective ENT Bone Procedures - Category 3           13      2,663 325 1891 10 3,250 18,910 15,660
DEN EL DENC34E Elective Mouth or Throat Procedures - Category 4             8      2,911 358 2067 18 6,444 37,206 30,762
DEN EL DENC35E Elective ENT Bone Procedures - Category 4           14      5,160 626 3664 37 23,162 135,568 112,406
DEN EL DENC44E Elective Mouth or Throat Procedures - Category 5 <70 w/o cc             9      5,796 702 4115 1 702 4,115 3,413
DEN EL DENJ37E Elective Minor Skin Procedures - Category 1 w/o cc             4      3,843 485 2729 0 0 0 0
DEN EL DENS22E Elective Planned Procedures Not Carried Out             9      2,417 292 1716 1 292 1,716 1,424
DEN EL DENUNCE Elective Dental Elective Uncosted HRGs           35      3,547 431 2518 20 8,620 50,360 41,740
DEN NE DENC14N Non-elective Mouth or Throat Procedures - Category 2           42         940 134 667 -27 -3,618 -18,009 -14,391
DEN NE DENC15N Non-elective ENT Bone Procedures - Category 2             1      2,680 324 1903 2 648 3,806 3,158
DEN NE DENC24N Non-elective Mouth or Throat Procedures - Category 3             2      1,489 193 1057 2 386 2,114 1,728
DEN NE DENC25N Non-elective ENT Bone Procedures - Category 3           62      2,986 382 2120 17 6,494 36,040 29,546
DEN NE DENC34N Non-elective Mouth or Throat Procedures - Category 4           13      1,107 158 786 -2 -316 -1,572 -1,256
DEN NE DENC35N Non-elective ENT Bone Procedures - Category 4           13      2,359 289 1675 -5 -1,445 -8,375 -6,930
DEN NE DENH44N Non-elective Major Cranial, Visceral or Blood Vessel Injury <70 w/o cc             7      1,125 138 799 1 138 799 661
DEN NE DENJ35N Non-elective Minor Skin Procedures - Category 2 w/o cc           16      1,972 233 1400 -5 -1,165 -7,000 -5,835
DEN NE DENJ37N Non-elective Minor Skin Procedures - Category 1 w/o cc             1      1,281 158 910 2 316 1,820 1,504
DEN NE DENUNCN Non-elective Dental Non Elective Uncosted HRGs           53         660 104 469 2 208 938 730
DEN OP DEN4AOP Out-patient Follow Up      6,537           20 2 15 818 1,636 12,270 10,634
DEN OP DEN4BOP Out-patient Outpatient Treatment      6,664           60 7 36 -776 -5,432 -27,936 -22,504
DEN OP DEN4COP Out-patient New Outpatient      5,139           80 8 67 -523 -4,184 -35,041 -30,857
DEN OP DEN4DOP Out-patient Outpatient Minor Ops      1,049         172 18 124 60 1,080 7,440 6,360
Dental subtotal               27,202 160,695 133,493
                       
DER DC DER4HX Daycase Day Unit - Nurse Treatment         147           40 10 20   0 0 0
DER OP DER4AOP Out-patient General Outpatient     11,932           39 9 35 1543 13,887 54,005 40,118
DER OP DER4BOP Out-patient Skin Surgery Outpatient         658           78 19 70 146 2,774 10,220 7,446
DER OP DER4COP Out-patient Lymphoedema Outpatient         289         152 37 137 84 3,108 11,508 8,400
DER OP DER4EOP Out-patient Unilateral Lymphoedema Treatment         274         299 74 269 251 18,574 67,519 48,945
DER OP DER4FOP Out-patient Bilateral Lymphoedema Treatment         261         592 148 533 85 12,580 45,305 32,725
Dermatology subtotal             50,923 188,557 137,634
                       
END DC ENDA15D Daycase Brain Tumours or Cerebral Cysts <70 w/o cc             7         612 266 551 43 11,438 23,693 12,255
END DC ENDK04D Daycase Anterior Pituitary Disorders           52         652 276 587 63 17,388 36,981 19,593
END DC ENDS25D Daycase Other Admissions           27         648 275 583 66 18,150 38,478 20,328
Endocrinology subtotal             46,976 99,152 52,176
                       
ENT NE ENTC02N Non-elective Nose Procedures - Category 1           28         502 97 331 -7 -679 -2,317 -1,638
ENT NE ENTC07N Non-elective Mouth, Head, Neck or Ear Diagnoses - Category 1 <70 w/o cc           50         419 87 277 -32 -2,784 -8,864 -6,080
ENT NE ENTC11N Non-elective Ear Procedures - Category 2             8         949 141 626 -5 -705 -3,130 -2,425
ENT NE ENTC12N Non-elective Nose Procedures - Category 2             4      1,387 266