We were commissioned by an acute provider to examine the activity behind their Top 50 Healthcare Resource Groups (HRGs) and provide a bottom-up costing of each HRG. By comparing this costing to the income received through NHS contracts, a rough profit or loss for each HRG could be calculated. This would then inform decisions about service development and areas for cost improvement.
The information was presented using “cost driver trees”, a graphical presentation of the income and costs of each HRG. We found this most useful when discussing the issues with clinicians and other non-finance colleagues. See an example cost driver tree here.
The cost driver trees follow the patient pathway for each HRG through costing each of the following areas:
|
2008/09 Forecast Activity |
2008/09 Forecast Income |
Avg Income per Spell |
||
|
(spells) |
(£) |
(£) |
||
| Phase 1: | ||||
| Maternity |
8,124 |
9,829,422 |
1,210 |
|
| Orthopaedics |
1,888 |
7,125,001 |
3,774 |
|
| Phase 2: | ||||
| General Surgery |
10,330 |
11,418,908 |
1,105 |
|
| Care of the Elderly |
2,514 |
9,128,717 |
3,631 |
|
| Gynaecology |
2,118 |
2,981,799 |
1,408 |
|
| Phase 3: | ||||
| Cardiology |
4,068 |
7,140,538 |
1,755 |
|
| Urology |
2,356 |
2,108,302 |
895 |
|
| Maxillo-facial Day Cases |
2,674 |
2,682,064 |
1,003 |
|
| Cataract Day Cases |
1,768 |
1,621,277 |
917 |
|
| Other Medicine |
266 |
1,119,833 |
4,210 |
|
| Clinical Haematology |
912 |
1,073,589 |
1,177 |
|
| TOTAL: |
37,018 |
56,229,449 |
1,519 |
|
| Total, all Admitted Patient Care |
62,272 |
96,817,821 |
1,555 |
|
| OVERALL COVERAGE: |
59% |
58% |
||