"The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood, who strives valiantly; who errs and comes short again and again; because there is not effort without error and shortcomings; but who does actually strive to do the deed; who knows the great enthusiasm, the great devotion, who spends himself in a worthy cause, who at the best knows in the end the triumph of high achievement and who at the worst, if he fails, at least he fails while daring greatly. So that his place shall never be with those cold and timid souls who know neither victory nor defeat." -Theodore Roosevelt

Thursday, 15 January 2015

The NHS and what us runners cost

I work, for the NHS, I've never hidden away from that and I'm proud to say I'm employed by what I think is a fantastic establishment. I'm not clinical, so I wouldn't be able to tell you symptoms, tests, or treatments to diagnose any weird or unheard of diseases (except for feed a cold, starve a fever maybe !). However, being a finance and performance employee I can tell you things that not many people know, as well as knowing things which everyone should know, but probably don't...

You'll all be aware of the A & E 4 hour wait time, and that hospitals must deliver this for 95% of their patients? That's a pretty standard one which is currently getting a lot of media coverage. Read headlines such as patients rocking up at A&E who don’t need to be there/should be going to their GP or Walk in Centre instead…

How about the 18 weeks referral to treatment rule? This one doesn't get the coverage I think it deserves... Every patient across the country has a statutory right under NHS guidelines to receive the start of their treatment within 18 weeks of their initial referral to be treated.

But what does that even mean?! Well, it means that if you go to your GP and they send you on to hospital, you must receive the treatment to whatever your ailment is within 18 weeks. Note the word TREATMENT here, tests & diagnostics do not constitute treatment.

So, if you end up being referred to hospital and require an operation, if your operation is not within 18 weeks from your initial referral to hospital, then the hospital has an obligation to move your operation date forward at their expense (this includes having your operation at another hospital if needs be in order to meet the 18 weeks target).

I find this extremely interesting and probably take waaaaay too much pride out of telling everyone I know about it. I get the same reaction every time though, glossed over eyes because they’re so busy concentrating on listening to what I've got to say J

The way the cost of your stay at hospital is calculated is equally as interesting; it’s unsurprisingly, based on your diagnoses and any procedures you have, as well as whether you attended A & E, you were admitted (be that in an emergency, or if it was planned), or if you 'simply' turned up for an appointment for a diagnostic test / examination from a doctor or consultant.

The combination of this ‘care setting’ you are treated under, and what your diagnoses / procedures are get mashed together into a magical algorithm to determine what your hospital stay costs.

So, what do runners cost? I’m just providing some generic, run of the mill costs which will likely be the pathway a runner would follow.

David goes to his GP with a hurty knee and is referred to hospital, where he is seen by a consultant. This will cost £119. If the consultant decides that David needs a scan, (likely a MRI scan), this will cost between £138 and £188 dependent on the number of areas scanned.

Following a scan, David goes to get his results, this will cost £70, as will every subsequent attendance with the consultant whether a scan has occurred or not.

If David is then sent for physiotherapy, this is where it gets a bit complicated; it doesn't cost the same at every hospital. Hospitals are generally paid a ‘block contract’ for physiotherapy, that is, they will employ a certain number of physiotherapists and be expected to treat all patients sent to them. These physiotherapists will often be expected to complete a patient's course of treatment within 4 – 6 visits. This will cost in the range of £25 - £65, but is different at each hospital, and should be used as a guideline only.

If, as I’m often reminded, that running ‘ruins your knees’ and a knee replacement is required, you’re looking at £9,000.
Now you have an idea of what runners cost, it realistically, is not huge sums of money, and will be little in comparison to other ‘self induced’ medical conditions…

One final note, none of the information I've posted, particularly around the costs above are a secret or confidential; they are free to view by anyone and everyone. Yu could just Google (other search engines available) PbR (Payment by Results) National Tariff and find the information.

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