Wednesday, 6 November 2013

Efficiency savings.

A former communist Party member called Nicholson in his infinite retardation once called for “efficiency” savings of £ 20 billion. Perhaps the good Sir’s expenses could count towards some of these and his comments about first class rail travel and why the good Sir uses it. We here at ND Central are sure the answer is because he can and it is a good communist ideal for the benefit of the plebs sorry comrades we meant the proletariat.

A recent late night discussion between the doctors at the infamous resistance Café Michelle revealed several sources of potential efficiency savings that have been going on for decades and were highlighted to the team in the last 2 weeks by patients whose care has been compromised by decades of institutionalized NHS mismanagement by the likes of Sir David “it wasn’t me” Nicholson. 
This is the “urgent scan” scam which predates the highly flawed NHS “market” but which the NHS Soviet market has refined beyond belief to ensure profit before patient. This is how the urgent scan scam works in today’s NHS market and we give you 3 options.

The first is that a doctor wants an urgent scan and this is from the first world (which is not the NHS) whereby if a scan is needed urgently it is done urgently based purely on true medical need no questions asked. This of course depends on the availability of scanners and the flexibility of the non medical workforce who are prepared to work beyond 17.00. In the NHS out of hours work usually attracts a premium so costs are bumped up.

The second urgent scan scam is the inpatient urgent scan scam.

Suppose you are admitted with a suspected attack of gallstone pain for the first time. You are treated for it with pain relief (the reason you went to hospital) but the consultant is not one hundred percent convinced that it is your gallbladder causing your pain. They therefore request an “urgent” ultrasound scan of your abdomen.

Now the “world class commissioned” patient centered NHS market only allows one scanner or a few scanners per hospital dependent on type for they are expensive and so elective scans (from GPs) generate more profit on a profit per scan basis while emergency admissions get this as part of their package or “bundle” of care. The same is true of outpatient care. So supposing your scan costs £ 300 if a GP orders it but if a GP refers you to a consultant as an outpatient costing say £ 200 the scan is included.

The only way the hospital gets income is to keep the patient admitted for say 4-5 days in order for the consultant, or more likely their most junior doctor, to blag an “urgent” inpatient scan because the patient is “ill” while they are well and sitting on a ward doing sweet FA and receiving no care as they are better. Just waiting for a scan. 

The maffs is this. 4 days as an inpatient costing say £ 200 a day to sit in a hospital bed for an ultrasound scan worth £ 80 results in the hospital pocketing £ 800 for doing nothing for a patient other than them sitting in a bed and being fed for less than the cost of a prisoner in the UK. 

The bed occupied by an otherwise well patient is then blocked for 4 days and this contributes to the A&E alleged crisis for it cannot take an acute admission. So bed occupancy is 100% target ticked but activity for that bed is zero until the “urgent” scan is done. And then the patient is discharged to return later for an outpatient follow up appointment (more cash) and if needed subsequent surgery (more cash) for the hospital for each patient so inconvenienced. We here at ND Central have seen several patients who after 3-4 days waiting (for nothing to happen) have taken their own discharges and come to ask us for an outpatient scan (more cash) because they cannot afford to be off work. 

The third scan scam is the outpatient urgent scan scam. 

Imagine your GP blags an urgent outpatient appointment (c £120-423) depending on specialty a shot because something doesn’t work in a patient but what your GP really wants is a scan costing c £ 78- 304 + the cost of reporting said scan £ 20-29. The only way that the consultant you can see can get an urgent outpatient scan is to admit you as an inpatient for an “urgent” scan.

Cost of scan = £ 78-304 + reporting £ 20-29. 

Cost of outpatient appointment £ 120-423.

Cost of inpatient bed for the sake of argument is £200 (more cash for an “emergency” than an elective admission) for every day waiting for “urgent” scan. So you can do the maffs and see how the cost of an emergency admission and outpatient appointment can cost more than the scan itself.

Now if each doctor in GP land in the UK has had as we here in Northenshire have had 1 each of the inpatient and outpatient urgent scan scam in the last 2 weeks then some simple maffs means that if each inpatient scan scam is rounded up to a grand (£ 1000) each week for each of the 34,101 GPs in the UK could lead to a potential saving of £ 34,101,000 every 2 weeks or a massive £ 886,626,000 a year. This of course does not include the outpatient scan scam figures. 

Makes the cost of treating overseas patient looks like peanuts compared with the costs that inefficient NHS managers incur by doing sod all. How many extra scanners and staff could you get for £ almost £ 1 billion of wasted NHS resource a year? That does not include the costs and inconvenience to the patients waiting as a result of the various scan scams. 

Praise be to the Party for ensuring that urgent care for those who need it is always blocked by those who believe that the system always comes before the patient for the system is always right. More efficiency savings vicar?

The system is after all always right and totally unaccountable so Nicholsonian it would be a joke if it wasn’t reality. Except his world is not that of patient care only that of patient exploitation to keep his kind in work.


FrankC said...

I wonder if that was why I was kept in hospital for four days for an infected finger? All I wanted was a hole in my fingernail to drain the crud.

Human Growth Hormone Houston said...

Αn imρreѕsive shaгe! Ӏ've just forwarded this onto a friend who has been doing a little homework on this.