This article explains the alternative, non-monetary values we have given to the productivity opportunities that you will find in the new version of the Model Health System at https://model.nhs.uk/opportunities.
For each opportunity we have expressed the estimated productivity gains in terms of units of clinical activity or numbers of additional staff, as well as cash amounts.
This is to help you visualise how much more clinical output you could potentially achieve, while spending the same amount, if you improved your productivity. Each opportunity explains whether your trust’s potential improvement is in comparison to all trusts nationally, or to a particular group of your peers, or is a trust-specific target.
For many clinical service lines, we have chosen one of the most frequently-reported activities for that specialty, using the HRG codes in Reference Costs. Each unit represents the national average (mean) cost of that activity, including adjustments for market forces factors.
For opportunities in other areas, we have shown you how many more registered nurses you could employ if you improved productivity while maintaining the same level of expenditure.
These examples are just a different way to illustrate the potential difference in productivity and it is up to trusts to uncover the reasons for variations, work out whether they are warranted or not, and realise any benefits in the way that provides the best outcomes for patients.
Table of units of clinical output for opportunities
This table provides the exact codes we've used, to help you understand how we've calculated the equivalent units for each opportunity. They are all taken from 2017/18 Reference Costs.
For other opportunities not in this table, we have used the average cost of a registered nurse. This is calculated used the metric Average Staff Cost - Registered Nursing & Midwifery Staff, found in the trust-level Nursing & Midwifery section of the Model Hospital. The value used for 2017/18 is £43,877.
|Opportunity||Service codes||Non cash units||National average cost||HRG description (Department)||Department code||Currency code|
|Breast surgery||Department Service code is 103 or currency code is JA*||core needle biopsies of the breast||£288.68||Ultrasound Guided Core Needle Biopsy of Lesion of Breast||OPROC||YJ13Z|
|Cardiology||Department Service code is 320||standard cardiac catheterisations||£1,020.46||Standard Cardiac Catheterisation with CC Score 0-1 (Day case)||DC||EY43F|
|Cardiothoracic surgery||Department Service code is 170, 172, or 173||registered nurses||£43,877||Average Staff Cost - Registered Nursing & Midwifery Staff (metric in Nursing & Midwifery, Trust-level)|
|Dentistry||Department Service code is 140 and currency code like CB* or WF*, or currency codes 141, 142, or 143||surgical tooth removals||£170.90||Surgical removal of Tooth, 19 years and over||OPROC||CD05A|
|Dermatology||Department Service code is 330||minor skin procedures||£150.44||Minor Skin Procedures, 19 years and over (Outpatient Procedures)||OPROC||JC43A|
|Diabetes and endocrinology||Department Service code is 302 or 307 or currency code is K*||short inpatient stays for non-complex diabetes||£399.85||Diabetes with Hyperglycaemic Disorders, with CC Score 0-1||NES||KB02K|
|Ear, nose and throat||Department Service code is 120||tonsillectomies||£1,450.34||Tonsillectomy, 4 years and over||DC||CA60A|
|Emergency medicine||N/A||registered nurses||£43,877||Average Staff Cost - Registered Nursing & Midwifery Staff (metric in Nursing & Midwifery, Trust-level)|
|Gastroenterology||Department Service code is 301||diagnostic colonoscopies||£512.56||Diagnostic Colonoscopy, 19 years and over||DC||FE32Z|
|General medicine||Department Service code is 300||short inpatient stays for non-complex sepsis||£491.31||Sepsis without Interventions, with CC Score 0-4||NES||WJ06J|
|General surgery||Service code is 100, or Currency code is F* or G*||diagnostic flexible sigmoidoscopies||£400.72||Diagnostic Flexible Sigmoidoscopy, 19 years and over||DC||FE35Z|
|Geriatric medicine||Department Service code is 430||complex pneumonia cases||£3,243.58||Lobar, Atypical or Viral Pneumonia, with CC Score 10-13||NEL||DZ11S|
|Medical and clinical oncology||Service code is 370, 503, 800||intravenous blood transfusions||£563.43||Single Plasma Exchange or other Intravenous Blood Transfusion, 19 years and over||DC||SA44A|
|Neurology||Department Service code is 400||registered nurses||£43,877||Average Staff Cost - Registered Nursing & Midwifery Staff (metric in Nursing & Midwifery, Trust-level)|
|Neurosurgery||Department Service code is 150||registered nurses||£43,877|
|Obstetrics and gynaecology||Department Service code is 501, 502, 503, 560||diagnostic hysteroscopies||£1,066.23||Diagnostic Hysteroscopy with Biopsy||DC||MA32Z|
|Ophthalmology||Department Service code is 130||cataract removal and lens implants||£902.41||Phacoemulsification Cataract Extraction and Lens Implant, with CC Score 0-1||DC||BZ34C|
|Oral and maxillofacial||N/A||registered nurses||£43,877|
|Orthopaedic surgery||Department Service code is 110, 108 or 323 or currency code is HC*||complex hip or knee procedures||
|Complex, Hip or Knee Procedures for Non-Trauma, with CC Score 0-1||EL||HN81E|
|Paediatrics||Department Service code is 290, NEO, PD, 422, 254, 220, 221, 321, 253, 255, 257, 263, 215, 252, 223, 251, 213, 256, 242, 280, 217, 260, 261, 259, 291, 421, 218, 216, 241, 219, 258, 262, 171, 222, 212, 214, 211, 420||paediatric minor infections||£569.73||Paediatric Minor Infections with CC Score 1-3||NES||PW01B|
|Plastic surgery and burns||N/A||registered nurses||£43,877|
|Respiratory||Department Service code is 340, 341, or 342||bronchoscopies||£726.30||Diagnostic Bronchoscopy, 19 years and over||DC||DZ69A|
|Rheumatology||Department Service code is 410||day cases with inflammatory spinal conditions||£379.07||Inflammatory Spine, Joint or Connective Tissue Disorders, with CC Score 0-1||DC||HC29B|
|Urology||Department Service code is 101||transurethral prostate resection procedures||£2,941.35||Transurethral Prostate Resection Procedures with CC Score 0-2||EL||LB25F|
|Vascular||Department Service code is 107||sclerotherapy treatments for varicose veins||£623.89||Sclerotherapy of Unilateral Varicose Veins||DC||YR33Z|