Out-Of-Hours Development Costings - Welcome to NHS Tayside

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					ANGUS LHCC
OUT OF HOURS COSTINGS



The attached summary paper details a funding requirement of £925,444 to enable the continuation
of the current OOH system in operation in Angus.
With the estimates of available funding provided by Sandy Berry, which gave Angus a figure of
£508,651, we have a shortfall of £413,793 to cover.

Given that Angus is already funding the majority of the additional Nurse staffing required to run
its enhanced Minor injuries and Illness Units through TASS monies, the significant remaining costs
are in respect of G.P. payments of £785,312 and Drivers payments of £86,514.

Angus is significantly further ahead in the development of its OOH service that our colleagues in Perth
and Dundee and in fact went live with the current system in January 2004.We have employed Drivers
and the system appears to be working well.The current funding of the Angus system is being made by
the Practices involved contributing the balance of their OOH Development Funds for 2003/04 plus the
Night Visit Fees they receive for the March 2004 quarter.Any required funding balance will be made up
by the Practices on an agreed basis.
In 2004/05, and until the PCO takes over the system, funding will be met through the Practices continuing
to Pay to the LHCC the notional amounts for the OOH Development monies and the Night Visit fees
that have been incorporated into their Global Sum, again with any shortfall being met by the GPs.

The biggest single funding gap therefore remains the actual payments that will be made to the GPs
in respect of their input to the service once the PCO takes over.
Angus is of the opinion that the input from the GPs is a vital part of our service and is in fact the lynchpin
on the entire system.We have developed the Non-Medical elements of the Service as far as we practically
can at this time and our fear is that if no further funds are made available then the entire Out of Hours
Service in Angus will collapse.

David Cook
  3/1/2004
he Practices continuing




 is in fact the lynchpin
 as far as we practically
OUT OF HOURS DEVELOPMENT COSTINGS - ANGUS                                                   Revised 01/03/04
INTERIM MODEL - OUT OF HOURS LOCATED AT ARBROATH INF/FORFAR INF.
2003/04

                                                     OPTION 1      Comments ….



STAFFING            GP's                                 785312    See attached GP time £737,489 plus £55,000 for Trust Practitioner Cover
                    Nurses                               193447    MIIU Nurse costs of £158k being met through TASS monies
                                                                   Balance of £35,447 comes from OOH funding for Forfar Practices.
                 CPNS                                     54000    CPNS costs being met through TASS Monies
                 Management Support                                Removed from local costings
                 Admin. / Medical Secretary               19628    10 hrs per week A&C 4 + 3 hours 7 days/week A&C4 at A.I.- attached
                 Drivers                                  86514    See attached schedule
                 Pharmacist                                6611    8 hrs/week Pharmacy Technician time for restocking-attached
TOTAL STAFFING COSTS                                    1145512

OVERHEADS           Rent & Rates                              0
                    Running Costs                          1000    Nominal sum for additional cleaning-all areas currently used/cleaned
TOTAL OVERHEADS                                            1000

VARIABLE            Leased Vehicle Costs x 2              10250    Prices confirmed via car leasing £5,125 each.
                    Transport Running Costs                6000    Fuel est for 2 vehicles x 20,000 miles each
                    Nurse Training                         9873    Nurse staffing turnover @ £1k each plus backfill
                    GP Training                            3648    2 sessions for 2 GPs per locallity
                    Clinical supplies                      3000    Gloves, thermometers etc
                    Communications                         4000    Includes phone system, mobiles and faxes.
                    Admin supplies                         3000    Postage/Stationery
                    Equipment replacement costs            2911    Based on 10% of Start-up Purchase costs
                    Equipment repair & maintenance         3250    Maintenance for security cameras, call recording , photocopier etc


TOTAL VARIABLE COSTS                                      45932

TOTAL REVENUE COSTS                                     1192444
                Less TASS/LHCC Funded                   -267000    Includes £158,000 for MIIU nursing,£54,000 for CPNS and £55,000
                                                                   for Trust Practitioner next day cover(£34,435 of which came from
                                                                   Arbroath Practices OOH funding transfer)
                    ADDITIONAL FUNDING REQUIRED          925444

                    AVAILABLE TAYSIDE FUNDING            -508651

                    SHORTFALL                            416793
OUT OF HOURS DEVELOPMENT COSTINGS - ANGUS
2003/04

GP COSTINGS - Revised Option                                                                                Annual     Annual     Weekly
                                              No of GP's       No of Hrs          Rate / hr    No of days    Cost       Cost       Cost     Comments …
                                                                                  £                           £          £          £

Weekday evenings       18.30 to 24.00                      2         5.5                 58          250      159500     159500      3190 Number of evenings excludes public holiday evenings

Overnight              24.00 to 08.00                      1          8                  92          361      265696     265696      5152

Saturdays              8.00 to 13.00                       2          5                  69           52       35880
                       13.00 to 18.00                      2          5                  69           52       35880
                       18.00 to 12 midnight                2          6                  69           52       43056     114816      2208

Sundays                8.00 to 15.30                       2         7.5                 69           52       53820
                       8.00 to 14.00                       1           6                 69           52       21528
                       15.30 to 12 midnight                2         8.5                 69           52       60996     136344      2622

Public Holidays        8.00 to 13.00                       2          5                  69            6        4140                        Includes six public holidays, excludes Christmas,
                       13.00 to 18.00                      2          5                  69            6        4140                        Boxing day, New Year and Jan 2nd
                       18.00 to 12 midnight                2          6                  69            6        4968      13248

Christmas              8.00 to 13.00                       2          5                  86            1         860
                       13.00 to 18.00                      3          5                  86            1        1290
                       18.00 to 12 midnight                2          6                  86            1        1032
                       12 midnight to 8.00                 1          8                 138            1        1104       4286

New Year               8.00 to 13.00                       2          5                  86            1         860
                       13.00 to 18.00                      3          5                  86            1        1290
                       18.00 to 12 midnight                2          6                  86            1        1032
                       12 midnight to 8.00                 1          8                 138            1        1104       4286

Boxing Day             8.00 to 13.00                       3          5                  86            1        1290
                       13.00 to 18.00                      3          5                  86            1        1290
                       18.00 to 12 midnight                2          6                  86            1        1032
                       12 midnight to 8.00                 1          8                 138            1        1104       4716

2nd January            8.00 to 13.00                       2          5                  86            1         860
                       13.00 to 18.00                      3          5                  86            1        1290
                       18.00 to 12 midnight                2          6                  86            1        1032
                       12 midnight to 8.00                 1          8                 138            1        1104       4286



STANDBY :-                                                                 Rate/hr based on
                                                                                8 hr session
Weekday evenings       18.30 to 12 midnight                0         5.5               3.625         250           0                    0
Overnight              12 midnight to 08.00                1           8                5.75         361       16606                  322
Saturdays              8.00 to 12 midnight                 1          16             4.3125           52        3588                   69
Sundays                15.30 to 12 midnight                1         8.5             4.3125           52        1906                   37
Public Holidays        8.00 to 12 midnight                 1          16             4.3125            6         414
Christmas - day        8.00 to 12 midnight                 1          16               5.375           1          86
Christmas - night      12 midnight to 08.00                1           8               8.625           1          69
New Year - day         8.00 to 12 midnight                 1          16               5.375           1          86
New Year - night       12 midnight to 08.00                1           8               8.625           1          69
Boxing Day / Jan 2nd   8.00 to 12 midnight                 1          16               5.375           2         172
Boxing Day / Jan 2nd   12 midnight to 08.00                1           8               8.625           2         138      23134


                                                                                                              730312     730312     13600 Weekly costs excludes public holidays
Note :-   1 Rates per hour utilised above are inclusive of on-costs (Employers national insurance and superannuation)

          2 Rates used for medical input are as follows:-

                                           Premium on                Pay            Full Costs   Comments …
                                               basic
                                                 %                     £                £
            Weekdays                         basic rate                50               58       18.30 to 12 midnight (mon to fri)
            Overnight                           60%                    80               92       12 midnight to 8 am (mon to sun)
            Weekends & PH                       20%                    60               69       8 to 13.00; 13.00 to 18.00; 18.00 to 12 midnight
            Christmas DAY                       50%                    75               86       8 to 12 midnight
            Christmas NIGHT                    140%                   120              138       12 midnight to 8 am
            New Year DAY                        50%                    75               86       8 to 12 midnight
            New Year NIGHT                     140%                   120              138       12 midnight to 8 am
            Standby                      50% of gross rate for particular session


            The above rates are entirely arbitary.
OUT OF HOURS DEVELOPMENT COSTINGS - ANGUS
DRIVERS
Costs based on 2003/04 rates of 5.8781 plus 5% est. for 2004/05 pay award
= £6.172 per hour plus on-costs = £6.87.

                                                 Driver
Cost element                     Hours          Rate        Total
Per week                                             £            £
Basic pay                                 90.00        6.87     618.30
Protection                                                          0.00
Low Pay Allowance                                                   0.00
Sat basic                                 26.50        6.87     182.06
Sun basic                                 34.00        6.87     233.58
Sat enh                                   13.25        6.87       91.03
Sun enh                                   34.00        6.87     233.58
O/T 3 hrs@T1/2 every 5 wks                             6.87         0.00
Total per wk                                                  1,358.54


Gross Charge per week                                           1,358.54

A/L & S/L say 10%                                                135.85

Total Cost per week                                             1,494.40

Public Holidays enh                      180.00        6.87     1,236.60
A/L & S/L say 10%                                                 123.66

Total Cost pa                                                  79,282.59                                     79,282.59

STANDBY (On call at home):-
                                                              Flat Rate Hours     fee/hour Days
Overnight (Mon to Sun)           12 midnight to 8.30                 7.00     8.5        0.77   250   3386
Saturdays                        See Below                           7.00   26.50        0.77    52   1425
Sundays                          See Below                           7.00   34.00        0.77    52   1725
Public Holidays                  0000 - 0830                        13.86     8.5        1.55    10    270
                                 1730 - 2400                        13.86     6.5        1.55    10    239
                                 1930 - 2230                        13.86       3        1.55    10    185    7231.47

                                                                                                             86,514.06
Arbroath Infirmary                 Provision of Drivers for LHCC OOH

Day                  Times         Hours
Monday               0000 - 0830           8.50 N
                     1730 - 2400           6.50 E1
                     1930 - 2230           3.00 E2

Tuesday              0000 - 0830           8.50 N
                     1730 - 2400           6.50 E1
                     1930 - 2230           3.00 E2

Wednesday            0000 - 0830           8.50 N
                     1730 - 2400           6.50 E1
                     1930 - 2230           3.00 E2

Thursday             0000 - 0830           8.50 N
                     1730 - 2400           6.50 E1
                     1930 - 2230           3.00 E2

Friday               0000 - 0830           8.50 N
                     1730 - 2400           6.50 E1
                     1930 - 2230           3.00 E2

Saturday             0000 - 0830           8.50   N
                     1000 - 1230           2.50   D1
                     1130 - 1745           6.25   D2
                     1745 - 2400           6.25   E3
                     1930 - 2230           3.00   E2        26.50

Sunday               0000 - 0830           8.50   N
                     0730 - 1430           7.00   D3
                     0830 - 1615           7.75   D4
                     1930 - 2230           3.00   E2
                     1615 - 2400           7.75   E4        34.00

                     Total             150.50

                                   New Staff
Hours                              Driver
Basic                                   90.00
Sat                                     26.50
Sun                                     34.00
total                                  150.50
OUT OF HOURS DEVELOPMENT COSTINGS - ANGUS

ADMIN/MEDICAL SECRETARIES (Assumes 5% pay increase over 2003/04 rates, includes on-costs)

ADMINISTRATION - Includes Drivers/GP Rotas, Staff Returns etc.
        10 Hours per week A&C 4(Top)
        £16,625 x 105% = £17,456 + on-costs £19,587/37*10 =               5,294

MEDICAL SECRETARIAL INPUT - Typing up Clinical Notes
        3 hrs per day - 7 days per week(mid)

          £9.22 x 21 hrs x 52.14 x 10.3% on-costs      11,135
          Sundays 3hrs x 9.22 x 52.14 x 10.3%           1,591
          P.H. 10days x 3hrs x 9.22 x 10.3%               305
                                                       13,031
          Holiday/Sickness cover @ 10%                  1,303
                                                       14,334


                                TOTAL                            19,628
OUT OF HOURS DEVELOPMENT COSTINGS - ANGUS

Pharmacy technician
(Assumes 5% pay increase over 2003/04 rates, includes on-costs)

8 hours per week to restock 4 MIIU Drug Cabinets

2003/04 cost wte =          19,069
+ 5% inflation              20,022
plus on-costs               22,533 x8/37            4,872

Assume annual leave/sickness @ 10%                    487
                                                    5,359
Travel     56 milesx 52 weeks x0.43p                1,252
                                                    6,611

				
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