The problem

The theatre and and anaesthetics clinical service unit (CSU) finance team need to monitor activity/expenditure of pass-through devices otherwise it risks under recovering on pass through income, and incorrectly stating their financial position.

The challenge

How might we leverage our expertise in patient level information costing system (PLICS) to develop an integration with the financial management world, enabling us to improve income recovery and device usage transparency? The goal is to ensure that our Trust can effectively recover costs and achieve overall financial sustainability.

The outputs

Through collaborative efforts with other finance teams, we have overcome several challenges and created two regular monthly reports that provide vital patient-level details to facilitate income recovery for corneal graft and Ilizarov frame activity.

The Ilizarov frame report is linked to the service level agreement management system (SLAMS) income record and links activity data from the theatre management system. This report confirms what income has been collected and “sold ,” and it identifies where activity has taken place but not yet been processed by the income team. As a result, this report provides transparency regarding further actions required to ensure complete income recovery.

Similarly, the corneal graft report collects activity data from the theatre management system and provides sufficient clinical and patient-level information, enabling the report to be matched to device invoices received in Oracle for payment. The addition of clinical information removes the burden on services for patient identifiers before invoices can be passed for income recovery, speeding up the checking process. Additionally, comparing the volume of actual activity to invoices received highlights whether there is a backlog in invoice authorisation.

These reports are crucial in ensuring that all income is recovered efficiently and accurately. By providing detailed patient-level information, they enable the swift reconciliation of activity and invoices, speed up the checking process, and allow for faster action to recover any unrecovered income.

The outcomes

The cross-team collaboration has brought numerous benefits, including providing valuable information that was previously not easily accessible and saving a significant amount of time during month-end processes. The reports created as part of this work have substantially reduced the number of queries directed to services for NHS number details, while simultaneously containing enough relevant information to be sent directly to the service or income for quicker processing. These innovations have facilitated a much leaner process and have embraced the Leeds improvement method, reducing waste across our Trust.

The reports have further enhanced transparency between activity and pass-through income recovery for these services with potential positive impacts on the Trust’s financial position. For instance, the Ilizarov frame report has highlighted five episodes in the last two months where income could have been missed if not checked, and at £6,700 per frame, it is crucial that the Trust maximises its potential for income recovery.

Lastly, the success of this project hinges on the collaborative efforts of every team involved, ensuring mutual agreement on collection rules and validation of the value of down-drawn income. Such cooperation by teams has promoted a proactive approach to missing income queries, allowing for prompt action and resolution of any issues that arise.