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Photodynamic Diagnosis of Bladder Cancer

Developing a Business Case

The implementation of this technology is likely to result in a change in costs to both the Trust and eventual long term savings (to both the Trust and to its Commissioners). There will be some costs that are covered by the current Payment by Results tariff (which the Trust receives for standard activity); however, there may be additional costs that will require the submission of a business case. It will therefore be essential to demonstrate that the additional costs likely to be incurred are covered and remunerated appropriately.

The local arrangements for approving business cases may vary from Trust to Trust but each organisation is likely to have its own template. In some Trusts, a business case may not be required at all, and an expanded Service Level Agreement between a Trust and commissioners may suffice.

Therefore the PDD Business Case Template provided in this is guide is generic in nature and should be read in conjunction with local business case guidance. The example template that NTAC provide should be amended and adapted as appropriate. It is provided in a Word document to allow users to copy and paste appropriate material.

Developing the Economic Case

A major objective of implementing the PDD technique is to allow surgeons to remove more effectively the Hexvix highlighted cancer within the bladder.

Current evidence suggests that adopting this technique will significantly improve clinical outcomes, reduce risk and allow for a reduction in follow up procedures. To achieve this there is a need to evaluate current and projected service requirements to calculate the effects of using the new technique on physical and financial resources.

A PDD Costing Model has been developed by the NHS Technology Adoption Centre with the support of the NTAC project implementation sites to assist managers and clinicians to calculate the potential impact of introducing the PDD technique. It specifically looks at:

Bed days.
Theatre sessions.
PbR (Payment by Results) income.
Pathology, staffing costs and equipment consumables.
Maintenance.
Capital charges.
Indirect costs.

The PDD Costing Model can be easily customised to take account of local factors such as length of stay, bed day costs and tariff, for example.

Note: Download a local copy of the Cost Savings Model from the resources on the left-hand-side of the screen. Please enable macro's to make full use of the Cost Savings Model tool. This tool currently runs from the Website when using Internet Explorer 7 - users who have earlier versions of Internet Explorer should download a local copy of the file.

Provision for National and Local Tariffs

It is hoped that in the future there will be specific tariffs under the Payment by Results regime to enable Trusts to cover the costs of the PDD technique.

For a full list (and guidance on) of the urology HRG codes available to Trusts under the current Payment by Results Regime see the DH Coding Document. PDD was recently awarded an OPCS 4.6 code which is Y37.1. The codes listed in the economic model are codes that the implementation sites are using in relation to their service costs. However there is flexibility in the economic model for a different code (and its associated costs) to be inputted to allow individual Trusts to work out their own figures as appropriate.