charles dickens - mr macawber;
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Mr Micawber's famous, and oft-quoted, recipe for happiness:
"Annual income twenty pounds, annual expenditure nineteen [pounds] nineteen [shillings] and six [pence], result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery."
Charles Dickens, David Copperfield
oscar wilde cost vs value:
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In Lady Windemere’s Fan, Oscar Wilde had Lord Darlington quip that a cynic was ‘a man who knows the price of everything and the value of nothing.‘
turnover vs profit:
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Turnover is the net sales generated by a business, while profit is the residual earnings of a business after all expenses have been charged against net sales. Thus, turnover and profit are essentially the beginning and ending points of the income statement - the top-line revenues and the bottom-line results.
having external staff foisted upon a business by a third party with renumeration increases turnover but not profits - the liability for redundancy costs etc becomes yours not the 3rd parties responsibility unless they are employed by the third party and seconded to you
reputation/brand/succession;
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like all business - brand and reputation = success, however if you are part of a subcontracted chain ie macdonalds the monoploy describes the repute/brand but you hold the liabilities - be careful to understand internal brand/repute vs external brand/repute.
bupa costings from danny;
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PbR tarrif hyperlink :
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https://improvement.nhs.uk/resources/national-tariff-1719/#h2-tariff-documents
Staff pay/salaries etc
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http://www.firstpracticemanagement.co.uk/knowledge-base/gp-practice-staff-pay-and-ratios-survey/
agenda for change pay scales;
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https://www.rcn.org.uk/employment-and-pay/nhs-pay-scales-2016-17
https://www.healthcareers.nhs.uk/about/careers-nhs/nhs-pay-and-benefits/agenda-change-pay-rates
CQRS data extraction [national pot]
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https://digital.nhs.uk/article/279/General-Practice-GP-collections
The Guernsey option [Jonathan Reggler].
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Dr Bob Hodges doc-store link to it;
https://www.doctors.net.uk/DocStore/DSView/Document.aspx?docid=774071
National LES list;
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Thanks to Essex LMC;
http://www.essexlmc.org.uk/wp-content/uploads/2013/11/CompleteLESBooklet.pdf
ownership of Citizens/patients
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the perennial their your patients via CCG or there my/our patients by Drs, is illusory nonsense.
in a socialized healthcare service the ownership of providing a service rests with the SoS for health and their delegated officers - aka commissioners. A providers remit is merely to provide what is agreed in contract - all services outside contract is the commissioners gig or the citizens gig. Patients are not owned by drs, Drs merely own the accountability to be responsible within contract to portray their craft, true ownership rests with commissioners, do not allow this to be foisted upon providers.
Local LES/NES/DES/LCSF stuff hyperlinked
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buggeration its on an intranet- ill get spec and renumeration and post as cut 'n paste
CQC- aRGHHHHHH
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Care Quality Commission (CQC) fees for registered providers 2017/18
10 March 2017
At the end of last year we carried out a public consultation regarding the increase in the fees that providers of health and adult social care in England will be charged from April 2017. I am writing to let you know that these changes have now been confirmed and are outlined on the fees page of our website, which also contains our response to the consultation and supporting information and guidance. The changes are to ensure that we can continue to register, monitor, inspect and rate services to make sure people receive care that is safe, effective, compassionate and high quality and we encourage services to improve.
I would like to thank everyone who took part in the consultation for your valuable contributions, which were all taken into consideration. We are fully aware that the increases agreed are not in line with what many of you would have desired and we acknowledge the strength of the feelings you expressed about the continued fee increases.
CQC is making savings over the period to 2019/20. In 2015/16 our budget was £249 million. The CQC budget for 2019/20 will be £217 million; a reduction of £32 million. During 2016/17 we have made over £10 million in efficiency savings and we are also moving towards fully recovering the chargeable costs of regulating health and adult social care.
The public are entitled to health and care which is safe, effective, high-quality and compassionate. CQC provides the public with independent assurance that services are operating in their interests. All providers of health and adult social care in England must be registered with CQC in order to provide services and the fee paid by providers is the charge for being registered with, and regulated by, CQC.
You can find the annual fee for your service for 2017/18 using the fees calculator published on our website. You can also find guidance on how and when to pay your fees, including information on paying by instalment.
In addition to the fee increases, we will also change two definitions in our fees scheme as set out in our consultation:
- Providers of substance misuse treatment services will be reclassified as providers of healthcare activities, rather than providers of care activities
- Providers of single-location NHS primary medical services, where all or part of that location is a minor injuries unit or an urgent care centre, will be charged on the same basis as single-location providers of NHS primary medical services where all or part of that location is a walk-in-centre.
The amounts providers will pay for their regulation will vary based on the type of health or social care offered, as well as how close the provider is to meeting the chargeable costs of their regulation in full. Examples of the changes providers can expect to their fees in 2017/18 include:
- £163 increase for a care home with 26-30 residents to £4,375 a year
- £823 increase for a single-location community social care provider (such as a home-care agency) to £2,192 a year
- £65,375 increase for a NHS trust with an income of £125 million to £225 million to £202,239 a year
- £1,952 increase for a single-location GP practice with 5,001-10,000 patients to £4,526 a year
- £113 decrease for a single-location dental practice with four chairs to £837 a year.
Our fees for 2017/18 represent 0.16% of overall indicative turnover of the health and social care market.
We would like to thank you for your continued support and involvement in working with us.
Yours sincerely,
Sir David Behan CBEChief ExecutiveCare Quality Commission
