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Related Experiment Videos

Contracting for clinical genetic services: the Welsh model

H E Hughes1, J K Alderman, M Krawczak

  • 1Institute of Medical Genetics, University of Wales Healthcare NHS Trust, Heath Park, Cardiff, UK.

Journal of Medical Genetics
|May 23, 1998
PubMed
Summary

A block contract pricing system for clinical genetics services in Wales proved economically feasible. This model recognizes non-medical staff contributions and covers comprehensive follow-up care.

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Area of Science:

  • Medical Services Research
  • Health Economics
  • Clinical Genetics

Background:

  • Healthcare reforms necessitate active health professional involvement in commissioning.
  • Specialized services like clinical genetics faced contracting challenges post-1990s UK NHS reforms.
  • Lack of consensus on contract currency complicated specialized service procurement.

Purpose of the Study:

  • To evaluate the economic feasibility and advantages of an average block contract price for clinical genetics services.
  • To assess the impact of this system on service provision and financial stability.
  • To analyze cost patterns and long-term financial risks associated with family genetics care.

Main Methods:

  • Analysis of five years of data (post-1992) on an average block contract price per referred family in Wales.

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  • Examination of activity data to understand cost variations across different genetic disorders.
  • Assessment of family file activation probability over time to determine long-term cost risks.

    • Main Results:

    • The average block contract pricing system is economically feasible for clinical genetics.
    • Advantages include recognizing non-medical staff, covering follow-up and counselling, protecting against non-attendance income loss, and aiding negotiation.
    • While most conditions cost below average, a few dominant and X-linked disorders influence the mean cost.
    • Long-term cost risk to providers is minimal due to decreasing family file activation probability.

    Conclusions:

    • The implemented block contract system offers economic viability and practical benefits for specialized clinical genetics services.
    • Accurate baseline data on referrals, activity, and staff costs are crucial for the system's robustness.
    • This model provides a stable financial framework for specialized healthcare services facing resource competition.