Saturday, 19 November 2011

Some NHS Analysis (1)

While this post covers a subject in its entirety, I think it's really two separate points, so I'm going to divide it into 2 parts.

The first part concerns a story I spotted on Google News about hospital appointments:-
Ashford and St Peter's Hospitals NHS Foundation Trust has hailed its new appointment reminder service as a great success, with the proportion of appointments missed in outpatients having dropped by around a third since the initiative was launched.
That's very, very good because we were told a couple of years ago that NHS Missed Appointments were costing £600m every year.

So, if we implemented such a system across the board, the NHS would save £200m/year.

I happen to work in software, and some years ago I worked on a system that had to send SMS messages to customers when their bills were ready to be viewed online. So, I know that setting such things up are quite straightforward and quite cheap (take the customer phone number and message and send it across to a bureau, job done). The bureau would charge us nearly 10p/SMS, although this is now down to nearer 5p/SMS. We then had to build and support the software. And 2 of us basically did this, along with everything else.

The Ashford trust used outbound dialing which has slightly higher costs, including slightly higher support costs. So, for the sake of argument, let's double the price.

Now, the Ashford trust said it had a 7.9% missed rate before, so with 6.5 million missed appointments, we can assume that the NHS makes a total of something around 100 million appointments. So, we'd have to send out 100 million SMS messages. Let's assume a total of £1m to run it and 10p for each call.

So, we'd have to spend £10m/year sending out reminders + £1m to run reminders, and the total saving would be £199m. If I could offer my clients such a high return on such a relatively small investment, they would bite my hand off.

And let me remind you, every figure used here for costs and percentage savings are all from the NHS. They've claimed these losses and also the percentages saved. And my figures are conservative of the sort of costs of implementation.

So why is it the case that this isn't across all hospitals? I know at least 2 trusts that don't do this. I also know that my dentist has had this in place (using SMS messages) for 4 years. The difference is of course that my dentist personally sees the benefit that a bureaucratic NHS manager doesn't see. 

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