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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      1,387 266 915 -3 -798 -2,745 -1,947
ENT NE ENTC14N Non-elective Mouth or Throat Procedures - Category 2           12         696 128 459 5 640 2,295 1,655
ENT NE ENTC16N Non-elective Mouth, Head, Neck or Ear Diagnoses - Category 2 >69 or w cc           21         872 119 576 -1 -119 -576 -457
ENT NE ENTC17N Non-elective Mouth, Head, Neck or Ear Diagnoses - Category 2 <70 w/o cc         130         513 96 339 130 12,480 44,070 31,590
ENT NE ENTC22N Non-elective Nose Procedures - Category 3         197         598 101 395 7 707 2,765 2,058
ENT NE ENTC24N Non-elective Mouth or Throat Procedures - Category 3           66         924 176 610 19 3,344 11,590 8,246
ENT NE ENTC31N Non-elective Ear Procedures - Category 4             1      3,652 324 2410 2 648 4,820 4,172
ENT NE ENTC32N Non-elective Nose Procedures - Category 4           11         838 151 553 19 2,869 10,507 7,638
ENT NE ENTF05N Non-elective Oesophagus - Therapeutic Endoscopic or Intermediate Procedures w/o cc           18      1,171 284 773 1 284 773 489
ENT NE ENTF08N Non-elective Disorders of the Oesophagus <70 w/o cc             5         291 50 192 5 250 960 710
ENT NE ENTP03N Non-elective Upper Respiratory Tract Disorders           25         381 78 251 8 624 2,008 1,384
ENT NE ENTS19N Non-elective Complications of Treatment           80         361 58 238 -6 -348 -1,428 -1,080
ENT NE ENTUNCN Non-elective ENT Non Elective Uncosted HRGs         161         965 176 637 22 3,872 14,014 10,142
ENT subtotal               20,285 74,742 54,457
                       
GYN NE GYNF42N Non-elective General Abdominal - Very Major or Major Procedures <70 w/o cc             2      4,216 860 2993 4 3,440 11,972 8,532
GYN NE GYNF44N Non-elective General Abdominal - Endoscopic or Intermediate Procedures <70 w/o cc           18      1,414 292 1004 -6 -1,752 -6,024 -4,272
GYN NE GYNM02N Non-elective Lower Genital Tract Intermediate Procedures           44         612 145 435 -22 -3,190 -9,570 -6,380
GYN NE GYNM05N Non-elective Upper Genital Tract Minor Procedures         294         354 98 251 28 2,744 7,028 4,284
GYN NE GYNM06N Non-elective Upper Genital Tract Intermediate Procedures           19      2,295 388 1629 6 2,328 9,774 7,446
GYN NE GYNM07N Non-elective Upper Genital Tract Major Procedures           84      2,347 424 1666 0 0 0 0
GYN NE GYNM09N Non-elective Threatened or Spontaneous Abortion         110         391 109 278 -37 -4,033 -10,286 -6,253
GYN NE GYNM14N Non-elective Non-Surgical Treatment of Fibroids, Menstrual Disorders, or Endometriosis         121         542 139 385 -71 -9,869 -27,335 -17,466
GYN NE GYNM15N Non-elective Non-Surgical Treatment of Ovary, Tube, or Pelvis Disorders           73         767 168 545 -13 -2,184 -7,085 -4,901
GYN NE GYNN12N Non-elective Other Maternity Events         149         747 151 530 29 4,379 15,370 10,991
Gynaecology subtotal             -8,137 -16,156 -8,019
                       
OPT DC OPTB02D Daycase Phakoemulsification Cataract Extraction with Lens Implant         742         913 198 639 167 33,066 106,713 73,647
OPT EL OPTB09E Elective Other Ophthalmic Procedures - Category 6           68      2,015 542 1411 14 7,588 19,754 12,166
Ophthalmology subtotal   #REF!         40,654 126,467 85,813
                       
NRE ? NRE1AX Back Inpatient Episode         107      6,938 156 1388 5 780 6,940 6,160
NRE ? NRE3AX General Inpatient Daily Charge      4,310         508 12 102      515 6,180 52,530 46,350
Neurorehab subtotal             6,960 59,470 52,510
                       
PCL DC PCLA01D Daycase Intracranial Procedures Except Trauma - Category 1             1         616 167 308 37 6,179 11,396 5,217
PCL DC PCLA07D Daycase Intermediate Pain Procedures         145         641 172 321 18 3,096 5,778 2,682
PCL DC PCLA08D Daycase Percutaneous Image Controlled Pain Procedures           10         788 246 394 -5 -1,230 -1,970 -740
PCL DC PCLUNCD Daycase Pain Clinic Daycase Uncosted HRGs           29         665 189 333 -29 -5,481 -9,657 -4,176
PCL OP PCL4AOP Out-patient Acupuncture         991             5 1 3 -996 -996 -2,988 -1,992
PCL OP PCL4COP Out-patient New Outpatient         755           52 14 27 86 1,204 2,322 1,118
Painclinic subtotal             2,772 4,881 2,109
                       
PLA DC PLAH13D Daycase Hand Procedures - Category 1           55         597 113 507 6 678 3,042 2,364
PLA EL PLAH13E Elective Hand Procedures - Category 1             3      1,360 250 1156 4 1,000 4,624 3,624
PLA EL PLAH14E Elective Hand Procedures - Category 2           10      1,430 269 1216 -1 -269 -1,216 -947
PLA EL PLAH15E Elective Hand Procedures - Category 3             5      1,606 301 1365 3 903 4,095 3,192
PLA NE PLAH13N Non-elective Hand Procedures - Category 1             3      1,609 255 1368 9 2,295 12,312 10,017
PLA NE PLAH14N Non-elective Hand Procedures - Category 2             5      1,107 201 941 0 0 0 0
PLA NE PLAC02N Non-elective Nose Procedures - Category 1           10         698 123 370 0 0 0 0
PLA NE PLAC11N Non-elective Ear Procedures - Category 2           12      1,128 208 598 5 1,040 2,990 1,950
PLA NE PLAC14N Non-elective Mouth or Throat Procedures - Category 2           59         597 111 316 2 222 632 410
PLA NE PLAC44N Non-elective Mouth or Throat Procedures - Category 5 <70 w/o cc             7      1,606 252 851 -1 -252 -851 -599
PLA NE PLAH17N Non-elective Soft Tissue or Other Bone Procedures - Category 1 <70 w/o cc             8      1,107 200 587 -1 -200 -587 -387
PLA NE PLAH18N Non-elective Soft Tissue or Other Bone Procedures - Category 2 >69 or w cc           15      2,848 531 1509 -3 -1,593 -4,527 -2,934
PLA NE PLAH19N Non-elective Soft Tissue or Other Bone Procedures - Category 2 <70 w/o cc         322      1,413 280 749 109 30,520 81,641 51,121
PLA NE PLAH20N Non-elective Muscle, Tendon or Ligament Procedures - Category 1             8      1,581 276 838 -2 -552 -1,676 -1,124
PLA NE PLAH21N Non-elective Muscle, Tendon or Ligament Procedures - Category 2           10      7,797 1,438 4132 -1 -1,438 -4,132 -2,694
PLA NE PLAH42N Non-elective Sprains, Strains, or Minor Open Wounds <70 w/o cc           19      1,083 199 574 17 3,383 9,758 6,375
PLA NE PLAH45N Non-elective Minor Fractures or Dislocations           52      1,190 234 631 40 9,360 25,240 15,880
PLA NE PLAH47N Non-elective Traumatic Amputations             4      4,458 801 2363 1 801 2,363 1,562
PLA NE PLAJ29N Non-elective Major Reconstructive Surgery           52      3,224 480 1709 12 5,760 20,508 14,748
PLA NE PLAJ30N Non-elective Major Skin Procedures >49 or w cc           47      2,017 301 1069 0 0 0 0
PLA NE PLAJ31N Non-elective Major Skin Procedures <50 w/o cc           93      1,595 273 845 15 4,095 12,675 8,580
PLA NE PLAJ32N Non-elective Intermediate Skin Procedures             6      5,676 859 3008 4 3,436 12,032 8,596
PLA NE PLAJ33N Non-elective Minor Skin Procedures - Category 3           57         994 171 527 3 513 1,581 1,068
PLA NE PLAJ34N Non-elective Minor Skin Procedures - Category 2 w cc             3      1,471 244 780 -1 -244 -780 -536
PLA NE PLAJ35N Non-elective Minor Skin Procedures - Category 2 w/o cc         147         735 143 390 23 3,289 8,970 5,681
PLA NE PLAJ37N Non-elective Minor Skin Procedures - Category 1 w/o cc         122         825 159 437 15 2,385 6,555 4,170
PLA NE PLAJ42N Non-elective Major Skin Infections <70 w/o cc           15      1,228 202 651 -2 -404 -1,302 -898
PLA NE PLAP15N Non-elective Accidental Injury           10         809 148 429 9 1,332 3,861 2,529
PLA NE PLAQ06N Non-elective Miscellaneous Major Vascular Procedures           12      2,421 436 1283 7 3,052 8,981 5,929
PLA NE PLAS22N Non-elective Planned Procedures Not Carried Out           22         852 160 452 1 160 452 292
PLA NE PLAUNCN Non-elective Plastic Surgery Non Elective Uncosted HRGs         158      1,581 254 838 30 7,620 25,140 17,520
Plastic surgery subtotal             76,892 232,381 155,489
                       
RHE OP RHE4AOP Out-patient Gold Clinic Outpatient      3,118           22 5 13 708 3,540 9,204 5,664
RHE OP RHE4BOP Out-patient Follow Up Outpatient      8,353           47 11 28 -1 -11 -28 -17
RHE OP RHE4COP Out-patient Bone Mineral Densitometry      2,232           69 16 41 -238 -3,808 -9,758 -5,950
RHE OP RHE4DOP Out-patient New Outpatient      1,568           70 17 41 307 5,219 12,587 7,368
Rheumatology subtotal             4,940 12,005 7,065
                       
TNO NE TNOH49N Non-elective Multiple Injury >69           15      4,648 1,163 4183 -2 -2,326 -8,366 -6,040
TNO NE TNOH50N Non-elective Multiple Injury <70           69      5,688 1,214 5119 -14 -16,996 -71,666 -54,670
TNO NE TNOH52N Non-elective Removal of Fixation Device <70 w/o cc           12         720 164 648 4 656 2,592 1,936
Orthopaedcs subtotal             -18,666 -77,440 -58,774
                       
URO OP URO4AOP Out-patient Follow Up Outpatient      4,889           65 18 44 641 11,538 28,204 16,666
URO OP URO4BOP Out-patient New Outpatient      2,360           83 23 56 -264 -6,072 -14,784 -8,712
URO DC UROL21D Daycase Bladder Minor Endoscopic Procedure w/o cc         850         231 50 164 -10 -500 -1,640 -1,140
Urology subtotal             4,966 11,780 6,814
Grand total               1,390,465 2,976,012 1,585,547

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