Please note that as of 1st April 2018 Heart of England NHS Foundation Trust (HEFT) has merged and is now part of University Hospitals Birmingham NHS Foundation Trust (UHB). The enlarged Trust will use the University Hospitals Birmingham NHS Foundation Trust name (UHB). All individual hospital and clinic names will remain the same, including the Birmingham Chest Clinic. For the purposes of this request we have answered on behalf of the newly formed UHB which covers Queen Elizabeth, Heartlands, Good Hope, Solihull Hospitals, Chest Clinic and community services.
However, due to historical differences in data collection we have provided separate responses based on the previous organisation’s.
Previous University Hospitals Birmingham NHS Foundation Trust, covering Queen Elizabeth Hopsital Birmingham:
1. Please could you provide me with your trust’s loss of income as a result of the cancelled elective or non-urgent surgeries this year? I understand that there are tariffs assigned for every procedure undertaken and that cancelling an operation results in the loss of that revenue.
2. I would like this data on a monthly basis from January 2018 to the last date for which the data is held.
3. If you have comparative data for Jan-Dec 2017 (on the monthly basis also), I would also like this. If there is any breakdown of this data (for example, tariffs lost, cost of surgeons not working and so on), could you provide that too?
The Trust does not hold information on “loss of income” due to cancelled operations. There are several reasons for this:
Firstly, the income due for a patient is only known accurately when the patients’ episodes of care has completed (when the patient has been discharged) and had the necessary clinical coding attached; income cannot be accurately assessed from the waiting list alone. Tariffs are based on healthcare resource groups (HRGs); there are over 2000 of these and casemix can differ widely.
Second, any cancelled operation is normally replaced with other activity, although the direct link between the cancelled procedure and the activity that proceeded in its place is not held, this is often not a 1:1 relationship.
Most of our clinicians have a mixed caseload of Elective and emergency work, and simply cancelling elective work does not result in a surgeon ‘not working’; Emergency activity has over-performed plan this year and this also attracts a revenue stream.
Previous Heart of England NHS Foundation Trust covering Birmingham Heartlands, Good Hope and Solihull Hospitals and Community services:
1. Please could you provide me with your trust’s loss of income as a result of the cancelled elective or non-urgent surgeries this year? I understand that there are tariffs assigned for every procedure undertaken and that cancelling an operation results in the loss of that revenue.
Please see below
2. I would like this data on a monthly basis from January 2018 to the last date for which the data is held.
Lost income compared to seasonal income plan
January 2018 – £2,002,000
February 2018 – £1,261,000
March 2018 – £1,979,000
3. If you have comparative data for Jan-Dec 2017 (on the monthly basis also), I would also like this. If there is any breakdown of this data (for example, tariffs lost, cost of surgeons not working and so on), could you provide that too?
January 2017 – £1,139,000
February 2017 – £623,000
March 2017 – £423,000
During the winter period there was a national directive to reduce the number of elective inpatient operations we perform and to prioritise those patients whom are most clinically urgent (e.g. operations to treat cancer) in order to accommodate emergency admissions.
The Surgical Consultant workforce continued to operate on cancer cases and urgent elective cases. Additional Emergency and Trauma Theatre sessions were provided to accommodate increased emergency activity. Additional outpatient clinic capacity was also provided.
