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“In austere financial times, which procedures should be rationed and who should decide?”

The Professor Harold Ellis Medical Student Prize for Surgery 2012. “In austere financial times, which procedures should be rationed and who should decide?”. Maral Rouhani 5th year Medical student University of Cambridge. The ‘Nicholson Challenge’.

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“In austere financial times, which procedures should be rationed and who should decide?”

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  1. The Professor Harold Ellis Medical Student Prize for Surgery 2012 “In austere financial times, which procedures should be rationed and who should decide?” • Maral Rouhani • 5th year Medical student • University of Cambridge

  2. The ‘Nicholson Challenge’ “NHS Trusts will have to deliver between £15 billion and £20 billion in efficiency savings over three years from 2011 to 2014.”1 1. David Nicholson speech to the Healthcare Financial Management Association, reported in the Daily Telegraph, 2009.

  3. Tonsillectomy Cataract removal Joint replacement “Procedures of Limited Clinical Value”

  4. Discrimination • 2. Debt • 3. Delays

  5. http://www.gponline.com/News/article/1136671/Exclusive-90-PCTs-rationing-care/http://www.gponline.com/News/article/1136671/Exclusive-90-PCTs-rationing-care/

  6. NICE NICE “Watch and Wait”2 “Only BMI over 50”3 2. http://www.oxfordshirepct.nhs.uk/professional-resources/priority-setting/lavender-statements/documents/LS68a_ElectiveSurgeryInguinalHernia.pdf 3. http://www.southstaffordshirepct.nhs.uk/policies/Commissioning/PolicyNo10BariatricSurgery.pdf Do you have an asymptomatic inguinal hernia in Oxfordshire? Need gastric banding/bypass in South Staffordshire?

  7. Discrimination • 2. Debt • 3. Delays • standardised evidence • long-term cost-effectiveness • patient care

  8. “I don’t know what I’m doing!” “Oh dear, we’re in a bit of a pickle.”

  9. AUDIT

  10. Reduce waste • Improve efficiency • early recovery programs • theatre change-over • faster PAC • PROCEDURES Save!

  11. these tailored In austere financial times, which procedures should be rationed?

  12. Thank you.

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