1. Simply….. How much does the NHS charge Gloria Middleton Westbourne Medical Group

2. Housekeeping Fire Alarms Toilets Fire Escapes Disabilities

3. Why you have been invited

4. How much of our budget goes to the Hospital ?

5. 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

6. Lets have a look at the pathway of care

7. 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

8. Accident & Emergency.. The true cost Minor Cost £59Minor Cost £59 Standard Cost £75Standard Cost £75 High Cost£117High Cost£117

9. How do we know how much everything costs ?

10. Business Information Reporting Tool To us known as …….BIRT

21. 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 infecJ440 Chronic obstruct pulmonary dis with acute lower resp infec J189 Pneumonia, unspecifiedJ189 Pneumonia, unspecified J459 Asthma, unspecifiedJ459 Asthma, unspecified Z720 Tobacco useZ720 Tobacco use Grouper allocated HRG codeGrouper allocated HRG code D39 - Chronic Obstructive Pulmonary Disease or Bronchitis w cc How much do you think that cost? £1459

22. 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 cement Z943 Left sided operation Grouper allocated HRG code:Grouper allocated HRG code: H80 - Primary Hip Replacement Cemented How much do you think that cost? £5,220

23. 9.4.2010 – 6.3.2011 Cost £33,321 25 contacts with hospital

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

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

26. Prescribing Some practice’s are over budget Not only because of the Clinicians prescribe BUT We have a lot of waste in the system.

27. 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%

28. If a patient is sick they should be in hospital….. Without a doubt If a patient is well enough to be cared for in another way and they are blocking a sick patient going into hospital then we should be able to do something about it…. One thing we do know is…

29. 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

30. 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

31. 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 !

32. So how much did you cost the NHS in 2010 /11 ? Why not ask your Practice Manager for a breakdown Of your hospital costs !