The bottom line is a reduction of 66,000 samples per year releases £750,000 back to the NHSMike Simmons
The primary outcome from Narrative Reporting is as we described under the “Why” tab, and as reported in our Journal of Infection Prevention paper, is the reduction in the number of specimens submitted as the comments modify the behaviour of the respondents and they begin to “own” the changes they need to think about in the context of the specific comments we are making. As described in “Why” section, we updated the changes reported in the published paper, which looked at the Hywel Dda data from September 2012, with the introduction of narrative reporting in September 2014 and up to September 2018. This review updates the figures to the end of April 2021.
The decline previously reported has continued although of course it is important to recognise the sudden decline in March 2020 was entirely due to the coronavirus pandemic. Before March 2020, the decline in total urines had reached 2,500 samples per month, which will amount to 30,000 samples per year. The negative urines have continued to see the bulk of the decline:
Whereas the positive urines have declined, although not at the same rate as is clear from the regression lines on the “Why” tab plot using Excel, no significant change is seen in the positive samples until the pandemic dip in March 2020
The data for the Betsi Cadwaladr Service was not included in the formal paper, being the “proof of concept” that was undertaken from August 2018. As with the original data for the Hywel Dda Service, we again went back two years to August 2016 and predicted a decline of 2,000 samples per month at the end of a year.
The decline seen is around 3,000 samples per month by February 2021. This amounts to 36,000 sample over a full year. Interestingly, the negative change point took longer to appear than was the expectation based on the Hywel Dda experience.
However, no change point was detected in the positive samples until the pandemic decline in March 2020
The Journal of Infection Prevention paper showed how we demonstrated that a reduction of 12,000 samples per year releases £145,000 of funds back to the NHS. We include the updated table from the paper below. This shows how a reduction of 66,000 samples per year releases nearly £750,000 back to the NHS, including a marginal real cost saving to the laboratories of more than £110,000 per year. These costs did not include any transport costs or the costs and sustainability issues associated with removing that many urine sample containers from waste streams.