Cost control of out-of-hours laboratory services in district general hospitals.
OBJECTIVE
To survey methods for cost control of out-of-hours laboratory services in district general hospitals in England and Wales.


METHODS
A questionnaire was distributed to 66 district general hospital laboratories in England and Wales.


RESULTS
The response rate was 61%. Most laboratories for which budgetary information was provided had on-call costs ranging between 10-21% of staff costs. Ninety five per cent of respondents had attempted to reduce workload by the use of various strategies. Seventy two per cent of responding laboratories had negotiated a wide variety of on-call agreements outside Whitley Council arrangements. Seventy two per cent were not satisfied with their on-call arrangements, the main desired objective being the introduction of the extended working day.


CONCLUSIONS
From this study it seems that Whitley Council agreements for out-of-hours work are no longer appropriate for the average district general hospital laboratory. Workload reduction strategies should include the use of a limited list, audit of the use of the on-call service, and continued education of medical staff. Consideration may also be given to the introduction of fixed payments, extension of the working day, increased multidisciplinary on-call and increased bedside testing.
Microbiology Department, Whiston Hospital, Prescot, Merseyside.
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KD
Allen
D003363:Cost Control / Q000379:methods* / Q000706:statistics & numerical data; D004739:England; D017721:Hospital Costs; D006767:Hospitals, District / Q000191:economics; D006769:Hospitals, General / Q000191:economics; D006801:Humans; D007755:Laboratories, Hospital / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014852:Wales; D016526:Workload