A newly created division ‘Financial Management’ has been established by the Ashford Healthcare Authority, a public healthcare authority that is responsible for the provision of public healthcare services in the Central region. Public healthcare is free at the point of use in the region in line with Government policy and is delivered through 22 different units under the following headings:
1. a major university teaching hospital,
2. a maternity hospital,
3. three smaller local hospitals,
4. seven steps down care units for post-acute hospital care, and
5. ten local clinics that do not have overnight accommodation.
The university teaching hospital has been in existence for more than fifty years but has been constantly upgraded, and some of the smaller local hospitals, step-down care units, and local clinics are relatively new but others are older and are due for an upgrade when capital funding becomes available. The older units cost more to run as they are less well designed and therefore need to have higher staff-to-patient ratios as the units are not as well laid out. They also cost more in terms of heating and maintenance, and in terms of maintenance of equipment, which can be a significant cost as under Health and Safety legislation there are prescribed schedules for lift maintenance for example, in case the lift failed, and a patient was stuck in it on the way to Theatre. All the units share one common characteristic which is that staff costs represent about 70% of their total costs and typically drugs and medicines represent another 10% of total costs although that is dependent to a certain extent on the type of activity carried out.
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