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With increasing financial pressure on the NHS the need to understand the treatment costs for patients is greater than ever. However, new research reveals that health organisations are struggling to identify the full costs of treating patients for all their care package, or care pathway.

ACCA and the Audit Commission have found that care pathways are altered, and commissioning decisions made, with the intention of benefitting patients, but often without fully understanding the cost implications. The researchers found that poor quality data across outpatient and community services was the most common barrier to costing the pathways.
 
Now, a new briefing Costing care pathways: Understanding the cost of the diabetes care pathway shows, using diabetes as an illustration, how organisations can use nationally available data to chart spending at a high level for various conditions. This information can then be used to help track changes in pathways and the impact on costs. It can also be used to compare costs between Primary Care Trusts and to identify possible areas for savings. We found that:

• the biggest driver of costs is diabetes medication which accounts for three quarters of the cost of diabetes care
• average primary care trust inpatient spend varies from £19 to £175 per diabetic patient
• community and outpatient cost showed the greatest variation, but the data was not sufficiently accurate to use in our analysis. 

Andy McKeon, Managing Director, Health, Audit Commission says “We know that healthcare organisations are striving to improve patient pathways to provide higher quality and more convenient care for patients.  But we need to find better ways to cost these changes. Our report shows what can be done using reliable national data to cost the diabetes care pathway. PCTs can also use it to compare their spending and to identify areas where they are likely to make the most savings and improve care.”

Mark Millar, ACCA Council member and Chief Executive of Milton Keynes Hospital NHS Foundation Trust says “Our research has clearly shown the potential for patient pathway analysis to contribute to the challenges facing the NHS and the need to improve the data collection and analysis to measure the potential benefits. In the meantime it is enormously difficult for the NHS to deliver effective plans for efficiency savings that we know are needed."

The briefing is supported by an online tool that will allow organisations to monitor and evaluate the cost of diabetes care in their area and to make comparisons with others, available at www.audit-commission.gov.uk/diabetescostcomparisons

Download a copy of the new report from www2.accaglobal.com/documents/CCP.pdf

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