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and I think that the majority of microbiology departments would consider themselves to be pretty lean anyway. I feel that we have always been responsible individuals, in the sense of not being profligate with resources and managing staff resourcefully whilst ensuring that we are operating in a cost and clinically effective manner.
“As in all branches of medicine, technological advances have provided us with increased opportunities to make new and faster diagnoses and there has been consequent rising public expectation of what can be provided by health services, but we have to remember that we only have finite resources. In this sense we are not unique, as all areas of the health service are having to tighten their belts.
“I think that the one area where we do feel additionally pressured at the moment is that the Carter report has now been published. Although the report recognises pathology and microbiology as an end to end service beginning with the patient, it also identifies a lot of potential for savings.
“These savings are quite substantial, when looked at in a national context, with different areas being given their own targets. My own region, the West Midlands, has been targeted with saving £50 million from its pathology services. This would mean taking £3 million out of my local service which in real terms over the next few years is a 20 per cent reduction in funding.
“It is difficult to know how much of that is going to be achievable and how much is going to be achievable year on year, because as we are already involved in yearly cost reduction programmes, one wonders how much more efficient we can be before the quality of services begin to suffer. Our main
Sep/Oct 10 nhe 41
concern is to maintain high quality diagnostic and infection management services.”
It seems that the scale of efficiency savings which have already been made by pathology and microbiology departments has already been so great that it could be hard to find room for anymore. Does Dr Stockley, believe that the Carter report was unfair in it search for more efficiencies?
“I think that the Carter report recognised that there was already huge value for money being achieved by these services alongside the fact that these services were of a very high quality as well. So I suppose we were then a little concerned and surprised that the report went on to identify huge amounts of money which could come out of the system. It seemed rather ambitious. I think that our role as professionals in delivering these services is to be responsible about our budgetary constraints while also making a case for what we think is core to our clinical purpose.”
One way which Dr Stockley believes efficiencies could be made is indirectly though optimal infection management, prevention and control.
“If the health service continues to bring down the rates of healthcare-associated infection, then this both affects the amount of resources required to deal with those infections and also frees up other resources to manage other patients.”
Dr Stockley is also very keen to point out that investment in diagnostic services can often reap rewards in other areas.
“By investing in diagnostic services, you can achieve cost savings in other areas. For example, by reducing the amount of time that people have to stay in hospital waiting for investigations and results. Faster results can lead to faster recognition of clinical problems, and prompt instigation of appropriate treatment. There are lots of studies which point to investment in diagnostics having a positive effect on both patient outcomes and also on the total resource usage through the health service.”
By spending money here, the NHS can save it elsewhere. This is the message coming from a group of NHS professionals which is very used to making efficiency savings. How much more efficient they can be remains to be seen.
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