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Welfare Reform on the Web (March 2010): National Health Service - funding

Are English treatment centres treating less complex patients?

A. Street and others

Health Policy, vol. 94, 2010, p. 150-157

Activity-based funding involves remunerating healthcare providers a fixed price per patient in each payment category. In principle, this can encourage efficient provision, inducing providers to reduce costs, increase activity and improve the quality of care. In practice, activity-based funding requires that remuneration adequately takes account of differences in patient care requirements. The English NHS has introduced treatment centres which concentrate on providing a small number of high-volume procedures. This analysis finds evidence that hospitals are treating patients of greater complexity than treatment centres. It is concluded that payments should be refined to reflect this fact, since treating patients with complex needs will drive up costs.

Bad medicine

J. Gee

Public Finance, Jan. 29th-Feb. 4th 2010, p. 24-25

It is estimated that more than 3.3bn of NHS funds are lost to fraud every year. Fraud is caused by patients providing false information to avoid prescription and dental charges, professionals claiming fees for work not undertaken, and contractors overcharging, under-supplying and forming cartels to rig the market. This article presents a blueprint for curbing fraud.

Clinical coding: are trusts being short changed?

D. Thavarajah and others

British Journal of Healthcare Management, vol.16, 2010, p. 26-31

Coding is often subject to inaccuracies on the part of clinical coders (non-medical staff) and this could be improved. The actual coding system itself is flawed and generates inaccurate healthcare resource groups. Financial loss or gain can be the result of these flaws and inaccuracies. This is unacceptable for a large organisation like the NHS and is ultimately detrimental to individual trusts, both financially and for provision of healthcare.

Cyclic factors behind NHS deficits and surpluses

R. Jones

British Journal of Healthcare Management, vol. 16, 2010, p. 48-50

The author argues that every 3-6 years a step increase occurs in medical hospital admissions and bed occupancy. This of course pushes up costs and is followed by efficiency measures which reduce its impact. The NHS needs to take these step increases in demand into account in its forward planning.

(See also British Journal of Healthcare Management, vol. 16, 2010, p. 94-95)

NHS hospital to be run by private company

S. Lister

The Times, Feb. 18th 2010, p.11

Hichingbrooke Hospital in Cambridgeshire is likely to be taken over and run by a private company, following the withdrawal of the only NHS organisation bidding for the contract. The successful applicant, which will be chosen by October, will be responsible for running the hospital which has an annual turnover of 92 million per year. Cambridge University Hospitals Foundation Trust, which was the only remaining NHS bidder, pulled out saying that the investments required in the bidding process risked affecting its other services.

Number of NHS senior managers has doubled, say doctors

R. Smith

Daily Telegraph, Feb. 12th 2010, p. 10

The British Medical Association has claimed that a fixation with the market has led to the NHS becoming bogged down in red tape and to significant waste of public money on ill-judged innovations such as independent treatment centres and private finance hospitals. It is launching a campaign to oppose commercialisation of the NHS.

Royal Surrey admits it traded drugs for profit

S. Gainsbury

Health Service Journal, Feb. 18th 2010, p. 7

The Royal Surrey County Hospital Foundation earned 4.6m over 10 months by buying up drugs at the NHS price and selling them on to a wholesaler for export. It ended the practice in January 2010, six months after the Department of Health had branded such trading wholly unacceptable as it was threatening the safe supply of medicines to the NHS.

SHAs plan staff cuts of up to 10pc

S. Gainsbury and D. West

Health Service Journal, Feb. 4th 2010, p. 4-5

Strategic health authorities are actively exploring cutting local workforces by up to 10% in order to make the 15bn-20bn savings required by 2014. Compulsory redundancies may be needed to achieve savings on this scale, alongside a raft of other changes to employment conditions. Unions are attempting to avoid redundancies by negotiating agreements for staff to work 'short time', eg three day weeks.

Why partnerships make total sense for savings

H. Mooney

Health Service Journal, Feb. 4th 2010, p. 24-25

Across the country 13 Total Place pilots are to look at all public spending in a range of service areas with a view to eliminating duplication, saving money and improving services. This article looks at how Croydon Primary Care Trust and Borough Council are using the scheme to focus on improving child health.

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