As the UK rapidly hurtles towards, what in 99 days, will be one of the most closely fought political elections in decades the NHS faces a period of unpredidented challenge in its 65 year history. A Malthusian challenge coupled with population growth and political uncertainty places strain on an already pressurised and much loved national institution.
For many, working for the NHS is a vocation of passion. It takes a certain type of compassionate individual who looks to care for the health of another, let alone someone with whom they have no initial emotional attachment but which rapidly grows to become the driving force to spur them on to continue to care and serve. What is currently being witnessed across all main parties is the use of the NHS as a political chess-piece upon which to hang a manifesto, when in reality rather than pledges the NHS needs a direct and clear plan focused on sustainable financial management which takes into account the accelerated population growth and aging population we face in a world much different to that of post-war 1948.
The reality is that with NHS faces a funding gap of up to £2bn – about 2% of its budget for the next financial year. Over 44% of NHS trusts are expected to end the year in a combined deficit with 64 of England’s 145 hospital trusts expecting ‘black hole’ predictions. Future estimates point to funding gaps of up to £54 billion by 2021 in addition to the some £20 billion in the year in hand which equating to annual deficits of a staggering £130 billion shortfall in the next 5 years alone. To future compound the problem savings targets of £1.5 billion are required by 2015/16 under the ‘Spending Round Settlement’, meaning In reality the NHS needs to have implemented a 0 % inflation policy for the last 2 years onwards out of its total net expenditure (resource plus capital, minus depreciation) – of £113.035bn (2014/15). For these reasons alone the unfortunate reality is that frontline staff are having to be as concerned with financial reporting as much they are by caring for the 1million patients which enter their doors every 36 hours.
There is however one area within those whom know patients best – NHS managers and employees be empowered to take control of finances and recover vital reinvestment for beds, employees and equipment.
Many will be aware of the 2007 the Department for Work and Pensions (DWP) ‘Injury Cost Recovery Scheme’ (ICR) which acts as a working framework to satisfy mandatory obligations to enable the national health service to recover costs pertaining to the treatment of patients of non-fault 3rd party road, occupational or public property accidents.
The legislation places a reciprocal legal obligation on NHS hospitals, Insurers and Solicitors which is two-fold:
- For at-fault Insurers to notify the Secretary of State (or the Scottish Ministers) within 14 days of all cases where a personal injury claim is/should be made using a CRU1 form and to seek a certificate of compensation and agree to pay proportioned the NHS costs
- For Hospitals and Ambulance Trusts to maintain a recorded mechanism allowing traceability and subsequent recovery of costs incurred by applicable patients and that, once in receipt, fill in and track the process of recovery using the issued Compensation Recovery Unit NHS2 form
- NHS expenditure equates to £3.4bn per year for the treatment of approximately 1.1 million 3rd party patient incidences
- Categorised ratios are: 800,000+ road traffic accidents, 150,000 occupation accidents and 130,000+ public property incidents
- Average case recovering should be over £1,700 per patient which can be reinvested into pay for staff and equipment
A more proactive leverage of this could provide sums exceeding the current recovery rate of £220m and much closer to recover much closer to £700m-1.3bn across some 3m UK accidents per year. On average only 20 percent or 2/10 of all UK accidents factor in medical costs even though NHS costs are budgeted and accrued with insurance companies in their actuarial costs. The main reason being that as many as 4/5 cases are closed down as pre-medical or general settlement cases which means that there is a reliance on the patient to articulate that as much as they want their car fixing they also want the treating NHS trust to be reimbursed for their cost of treatment.
2013 Health and Social Care Act, guidelines and directives around process and recovery levels are laid out within Section 23 of the 2014 NHS Manual for Accounts and costs as laid out by The Department of Work and Pensions are as follows:
- Ambulance – per person per journey – £192.00
- Outpatient treatment (including A&E) – £637.00
- Inpatient treatment – £783.00 per day
- To a maximum per patient of £46,831.00
Healthcare Cost Recovery Ltd (HCR) provides an absolutely free of charge solution to the NHS which in no way changes the current processing of the funds recovery but which overcomes the problem of 19% of all NHS2 forms being classified as ‘unqualified’, removes the onus from reliance on the discretion of an at-fault insurer to follow process and greatly improves both reconciling and tracing of NHS2 pay-outs whilst educating a population of patients as to how they can support the NHS to gain vital reinvestment.
The key to maximizing recovery is ensuring that NHS frontline staff gain increased control on the process so that in every case of an accident where there is a third party accountable there is recovery to the NHS. More importantly is that this is done in a way which is of minimal time allowing for the practicality of a busy ward or department. HCR believes patient care should be the core focus of the NHS not recovery of costs. Our complimentary system ensures that the NHS can meet its obligations under to 2013 Healthcare Reform Act and 2014 section 23 Manual for Accounts whilst using HCR’s trusted SRA (Solicitors Regulatory Authority) and FCA (Financial Conduct Authority) expertise, regulated process and cover.
To support the NHS, our teams liaise with affected patients, insurance companies and solicitors to provide a high success ratio of recovered costs with little NHS staff involvement and tracks, liaises and assists with the fund allocation which is administered through the Compensation Recovery Unit (CRU) department of the DWP and managed under the Ministry of Justice and Solicitors Regulation Authority system & regulation.
Working with the NHS, Healthcare Cost Recovery Ltd has created the technology and reporting mechanisms to develop a process which ensures that in every applicable accident where treatment has been given, the third party corporation or insurer is advised directly by the NHS thus reinforcing the obligatory notification from the insurer to the DWP CRU and trigger of NHS2 form.
In the same way that the private healthcare sector recovers costs, HCR empowers the NHS to have a compliant record of treatment given with a simple tracing system to ensure return of expenditure for re-investment. By capturing all applicable patients, HCR’s cloud based, secure and encrypted patient centric closed loop system ensures that all pre-med, voluntary and general settlement cases are captured ready for the DWP CRU process to begin ensuring that vital funds are not lost at any point within the process.
Accessible from any ward workstation or device by using only three simple pieces of information the HCR interface captures the requirements to start the process of cost calculation from the ‘at fault’ insurance company including everything from ambulance call-out, specialist medications, x-rays and scans to in-patient care and outpatient referrals.
Not only does it take less than only 12-15 seconds to fill out and allow HCR to fully manage the recovery process but our system drives down the waste of time which the NHS has to currently spend filling out forms where the liability and responsibility for cause of accident has not been established.
In the words of Sir Bruce Keogh….. ‘The NHS is an international icon of the British social conscience, designed to replace fear with hope. It’s owned by the people for the people, funded by everyone for everyone. Irrespective of age, social status, race or creed. We want to help the public to assist the NHS to continue to be so.
To discuss how your trust can benefit from a completely free of charge system to help with vital reinvestment please contact.