Get documents about "Urgent care cost model
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- 12/11/2011
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Document Sample
Urgent Care Centre - Front End Registration (0910 Activity Base)
Acute Unit Whittington
Annual Activity 80,000
Activity 9am - 9pm 61,395 77%
Activity 9pm - 9am 18,605 23% 21394.76
Core Hours Activity
High 3,844 6%
Standard 4,280 7%
Minor 5,086 8%
Total Ambulance 13,210 22%
High 10,476 17%
Standard 7,752 13%
Minor 29,957 49%
Total Foot 48,185 78%
Check 0 0%
Streaming Activity 61,395
Minor Activity To Other Primary Care 10% 4,000
Core Hours Streaming
Streamed to Emergency Dept - High 100% 14,320
Streamed to Emergency Dept - Standard 59% 7,075
Streamed to Emergency Dept - Low 0% 0
21,395
To ED Depart 40,000 check 0
Registration (Charging Point)
High 0
Standard 4,957
Minor 31,043
36,000
Check 0
UC & Other Primary Care 40,000 50%
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Urgent Care Centre - Front End Registration
Streaming Activity pa Activity per day
Core Hours to Emergency Dept 7,075 19
Core Hours to Other Primary Care 4,000 11
Core Hours to Other UC Registration 36,000 99
Total Streaming Activity pa 47,075 129
Patient registration (pay point) 36,000
Assessment & Treatment 36,000
Activity 100% average activity per hour staff required per Hour
Total GP &
Stream Assessment & Nurse WTE Admin Excess GP &
Streaming Assessment & GP & Registration Treatment GP (rounded (rounded Nurse Staff
Activity Timing per day Registration Treatment Nurse Admin & Nurse 2dp) 0dp) (rounding)
09:00 6.6% 9 7 7 0.71 0.54 1.63 2.40 1.00 0.06
10:00 8.2% 11 8 8 0.88 0.68 2.03 3.00 1.00 0.09
11:00 8.8% 11 9 9 0.95 0.73 2.18 3.20 1.00 0.07
12:00 8.8% 11 9 9 0.95 0.73 2.18 3.20 1.00 0.07
13:00 8.7% 11 9 9 0.94 0.72 2.15 3.10 1.00 0.01
14:00 8.3% 11 8 8 0.89 0.68 2.04 3.00 1.00 0.08
15:00 8.2% 11 8 8 0.88 0.67 2.02 2.90 1.00 0.00
16:00 7.9% 10 8 8 0.85 0.65 1.95 2.90 1.00 0.09
17:00 7.8% 10 8 8 0.84 0.64 1.92 2.80 1.00 0.04
18:00 7.6% 10 8 8 0.82 0.63 1.88 2.80 1.00 0.09
19:00 7.1% 9 7 7 0.76 0.58 1.74 2.60 1.00 0.10
20:00 6.2% 8 6 6 0.67 0.51 1.53 2.30 1.00 0.10
21:00 5.6% 7 6 6 0.61 0.46 1.39 2.00 1.00 0.00
Total Per day Activity 129 99 99 Staff required Per shift 3.00 1.00
Total per annum Activity 47,075 36,000 36,000
NB: Activity throughout the days of the week is broadly equitable
Time Taken Cost for Time
Streaming
Receptionist 0 £ -
GP 5 mins £ 6.82
Practise Nurse 0 £ -
Registration
Receptionist / Admin 5 mins £ 1.85
GP 0 £ -
Practise Nurse 0 £ -
Assessment & Treatment
Receptionist 0 £ -
GP 15 mins £ 20.46
Practise Nurse 0 £ -
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Urgent Care Centre - Financial Summary - UCC Activity 40,000
Staff Costs
Annual Costs
Grade WTE (inc On Costs)
GP 5.64 £ 720,636
A&E Nurse 2.78 £ 167,106
GP Training (assumed % of GP WTE) 0.56 10% £ 72,064
Admin 2.65 £ 97,236
Management Costs 1.00 £ 60,119
£ 1,117,161
Non Pay
Non Pay (assumed % of Pay) 27% £ 301,633
£ 301,633
Diagnostics
test Cost per test % Activity Activity Total Cost
ECG 22.00 18% 892 £ 19,630
Urinanalysis 5.00 27% 1,338 £ 6,692
Blood 5.00 13% 644 £ 3,222
Other 10.00 5% 248 £ 2,479
Other (includes Radiology which remain
unspecified on reports) 20.00 37% 1,834 £ 36,683
£ 68,706
Overheads
Estates Costs and IM&T (% staff costs) 45% £ 502,722
Management - Other (% staff costs) 5% £ 55,858
£ 558,580
Tariff Streaming to OPC £ 12.00 4,000 £ 48,000
Total Costs £ 2,094,081
Activity 36,000
Cost Per Case (inc MFF) £ 56.84
Staff Max
GP 67%
A&E Nurse 33%
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Urgent Care Centre
Urgent Care Activity Not In A&E Whitt RKE
Activity PbR (1011) MFF Total £
Activity To Other Primary Care Minor 4,000 59 1.30 307,116
Assessment & Treatment Minor 31,043 59 1.30 2,383,441
Assessment & Treatment Standard 4,957 87 1.30 561,233
Cost of UC Activity in A&E 3,251,789
UCC Costs
Staff 1,117,161
Non Pay 301,633
Diagnostics 68,706
Overheads 558,580
Tariff Streaming to OPC 48,000
Cost of Running UCC 2,094,081
Cost Saving / (Higher Cost) 1,157,708
Savings Via
Activity To Other Primary Care 259,116
Cheaper UC service through difference service design 898,593
Savings Total 1,157,708
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Assumed Costs for Staff Resources
14% 0%
Productiv
Nat e Days Productiv
spine 10/11 Basic London Insurance - Pension - Total Annual GROSS Annual per Cost per e Hours Cost per Cost per
Staff Grades (mid Points) Grade pt Pay Weighting ers ers Cost per WTE Admin Cost per WTE Annum Day per Day Hour Minute
Band 3 Admin 3 £ 17,118 £ 4,036 £ 1,976 £ 2,962 £ 26,092 £ - £ 26,091.75 220 £ 118.60 7.50 £ 15.81 £ 0.26
Band 4 Admin 4 14 £ 19,993 £ 4,036 £ 2,344 £ 3,364 £ 29,737 £ - £ 29,737.25 220 £ 135.17 7.50 £ 18.02 £ 0.30
Band 5 5 19 £ 24,554 £ 4,911 £ 3,040 £ 4,125 £ 36,630 £ - £ 36,629.85 220 £ 166.50 7.50 £ 22.20 £ 0.37
Band 6 Physio 6 25 £ 29,464 £ 5,893 £ 3,794 £ 4,950 £ 44,101 £ - £ 44,100.90 220 £ 200.46 7.50 £ 26.73 £ 0.45
Band 7 Nurse 7 30 £ 35,184 £ 6,217 £ 4,568 £ 5,796 £ 51,765 £ - £ 51,765.23 208 £ 248.87 7.50 £ 33.18 £ 0.55
Band 8A 8A 35 £ 41,772 £ 6,217 £ 5,411 £ 6,718 £ 60,119 £ - £ 60,118.53 208 £ 289.03 7.50 £ 38.54 £ 0.64
Consultant Consultant £ 130,000 £ 6,217 £ 16,704 £ 19,070 £ 171,992 £ - £ 171,991.64 208 £ 826.88 7.50 £ 110.25 £ 1.84
GP GP £ 95,065 £ 6,217 £ 12,233 £ 14,179 £ 127,694 £ - £ 127,694.06 208 £ 613.91 7.50 £ 81.86 £ 1.36
0
0
NB 2: Productive days (i.e. less than the full c220 days), are due to Training needs etc. These are calculated as follows:
0
Consultant, 7 &
8a Nurse Band 4 Admin Band 5 - 6 UCC Hours Open 4380 hrs pa
Days Nurse / GP hrs 1560 hrs pa
Days pa 365 365 365 Admin Hrs 1650 hrs pa
Bank Holidays (8) (8) (8)
Weekends (104) (104) (104) 2.654545
Annual Leave (30) (22) (22)
Sick Leave (5) (5) (5)
Training (10) (6) (6)
208 220 220
100% Utilisation 208 220 220
It was suggested by the UCC at RFH to pay GP's on an hourly "freelance" basis. This is because they consider that:-
a) attracting GP's to work solely in a UCC may not attract the right calibre of staff or be veiwed as a long term career
b) employing (already) working GP's will ensure they want to work. At RFH sickness etc is minimal and the shift rota is full into 2011
c) "freelance" GPs do not incur 'on costs' as these are self employed. Therefore rates can be higher. At the RFH they pay:-
i) £80 per hour standard time
i) £85 per hour weekends
i) £100 per hour bank holidays
Average Wage Calculation
£ £
UCC Hours Open Per Year 4380 hrs
Week 3036 hrs £80 £242,880
Weekend 1248 hrs £85 £106,080
Bank Holiday 96 hrs £100 £9,600
£358,560
Average per hr £81.86
The GP salary has been increased from £90k + LWA to bring in line with the hrly rate suggested (average £81.86)
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Equivalent Costs of Streaming To OPC
Mins Taken Cost / Min Cost / Activity £
Receptionist (Gr 5) 2 £ 0.37 £ 0.74
GP 5 £ 1.36 £ 6.82
Estate & OH £ 4.09 £ 4.09
£ 11.65
