Monday 1 June 2009

World Class Commissioning could save PCTs £3bn over 5 years


With savings like these, NHS could become a net contributor to the Treasury!
£50,000 per QALY (Quality Adjusted Life Year - the value assigned by statisticians that an individual puts on being healthy for a year) is a reasonable figure, but lets not get mixed up - nobody gets £50,000 in their hand, least of all government (who may have to pay for statins or insulin during that extra year of life).
It's a common misconception that "savings" achieved by transforming healthcare or social care can be counted by adding up the pounds. For example, if an IT project saves 3 minutes per patient search, then how much does it save over a month? Well lets assume that the GP surgery does 100 such searches per day, sothat's 300 minutes. And of course all of the savings can be turned into money, at £10 per hour that's £50 per day. Who gets the savings? Certainly not NHS - as I said, faced with spending 5 hours per day on searches that aren't essential and are only ever used for some admin, most GP surgeries would just not do them.
QALYs are very important to NICE (National Institute for Health and Clinical Excellence) for determining whether a particular treatment represents value for money - if a course of medication extends life by 6 months, then it represents value for money if it costs less than £25,000 (6 months * the value of a QALY), and not value for money if it is more expensive. But you or I can't bank the money. If I were on death's door I would be prepared to spend everything I have for a little extra time, and that might be £50,000 or more, or it might be a lot less.

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