It is difficult to ignore the present reality in the NHS that understanding clinical coding is perhaps of more relevance to the practising clinician than the human genome! Clinician engagement is becoming more essential to protect patient care and maximise potential service delivery and it is naturally important that ENT isn’t left behind. This retrospective financial analysis takes a single consultant experience over a two year period and looks to explore the variables that determine cost and profit for major ear surgery using real accountancy and theatre data. The overall complexity of the presently used ‘payment by results’ system is highlighted by the authors and the frequent disparity between the service delivered and the cost required to deliver that service is made clear.

Only 21 out of 76 patient spells returned a profit with an overall net loss of £-1345.50 per patient. Most critically there was a strong relationship between overall theatre time and total costs.

Only 6% of variation in earnings was due to factors other than theatre time or chance which appears staggering. As surgeons we will be subject to increasing analysis on profitability, therefore a greater understanding of the process is required. Driving forward accurate tariff remuneration is a key part of that process and articles such as this are an important step in the right direction. 

A break-even analysis of major ear surgery.
Wasson JD, Phillips JS.
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Andrew Hall

North Thames, UK.

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