With increasing financial pressure on the NHS the need to understand the treatment costs for patients is greater than ever. However, new research reveals that health organisations are struggling to identify the full costs of treating patients for all their care package, or care pathway.
The Audit Commission and Association of Chartered Certified Accountants (ACCA) has found that care pathways are altered, and commissioning decisions made, with the intention of benefitting patients, but often without fully understanding the cost implications. The researchers found that poor quality data across outpatient and community services was the most common barrier to costing the pathways.
Now, a new briefing Costing care pathways: Understanding the cost of the diabetes care pathway (link to report in MSWord version attached) shows, using diabetes as an illustration, how organisations can use nationally available data to chart spending at a high level for various conditions. This information can then be used to help track changes in pathways and the impact on costs. It can also be used to compare costs between Primary Care Trusts and to identify possible areas for savings.
We found that:
- the biggest driver of costs is diabetes medication, which accounts for three quarters of the cost of diabetes care;
- average primary care trust inpatient spend varies from £19 to £175 per diabetic patient; and
- community and outpatient cost showed the greatest variation, but the data was not sufficiently accurate to use in our analysis.
Andy McKeon, Managing Director, Health, Audit Commission says "We know that healthcare organisations are striving to improve patient pathways to provide higher quality and more convenient care for patients. But we need to find better ways to cost these changes. Our report shows what can be done using reliable national data to cost the diabetes care pathway. PCTs can also use it to compare their spending and to identify areas where they are likely to make the most savings and improve care."
Mark Millar, ACCA Council member and Chief Executive of Milton Keynes Hospital NHS Foundation Trust says "Our research has clearly shown the potential for patient pathway analysis to contribute to the challenges facing the NHS and the need to improve the data collection and analysis to measure the potential benefits. In the meantime it is enormously difficult for the NHS to deliver effective plans for efficiency savings that we know are needed."
The briefing is supported by an online tool that will allow organisations to monitor and evaluate the cost of diabetes care in their area and to make comparisons with others, available at www.audit-commission.gov.uk/diabetescostcomparisons
Notes to editors
In order to illustrate the approach, the report looked at care for patients with diabetes mellitus. The research team chose to concentrate on diabetes because it is:
- a popular area for pathway development;
- fast growing, both in terms of population and patient cost; and
- estimated to cost £9 billion per year, accounting for 10 per cent of all NHS spending.
1. ACCA (the Association of Chartered Certified Accountants) is the global body for professional accountants. We aim to offer business-relevant, first-choice qualifications to people of application, ability and ambition around the world who seek a rewarding career in accountancy, finance and management.
2. ACCA supports 147,000 members and 424,000 students in 170 countries, helping them to develop successful careers in accounting and business, with the skills required by employers. ACCA works through a network of over 80 offices and centres and more than 8,500 Approved Employers worldwide, who provide high standards of employee learning and development. Through our public interest remit, we promote appropriate regulation of accounting and conduct relevant research to ensure accountancy continues to grow in reputation and influence.
3. Founded in 1904, ACCA has consistently held unique core values: opportunity, diversity, innovation, integrity and accountability. We believe that accountants bring value to economies in all stages of development and seek to develop capacity in the profession and encourage the adoption of global standards. Our values are aligned to the needs of employers in all sectors and we ensure that through our qualifications, we prepare accountants for business. We seek to open up the profession to people of all backgrounds and remove artificial barriers, innovating our qualifications and delivery to meet the diverse needs of trainee professionals and their employers.
4. The Audit Commission is an independent public corporation set up in 1983 to protect the public purse. We promote value for money for taxpayers in the £200 billion spent by 11,000 public organisations.
5. The Commission appoints auditors to councils, NHS bodies (excluding NHS Foundation trusts), police authorities and other local public services in England and oversees their work. The auditors we appoint are either Audit Commission employees (our in-house Audit Practice) or one of the private audit firms. Our Audit Practice also audits NHS foundation trusts under separate arrangements. We also help public bodies manage the financial challenges they face by providing authoritative, unbiased, evidence-based analysis and advice.
For further information please contact:
Ray Allger, ACCA UK Newsroom
Tel: 020 7059 5788
Mobile: 07540 919819
Email: ray.allger@accaglobal.com
or
Nick Rigg
Corporate Communications Manager,
Audit Commission Press Office: 0207 166 2128 Direct line 0844 798 2916
Email: n-rigg@audit-commission.gov.uk