Blood pressure monitoring

Lots of stuff on the news today about the NICE guidance that all new patients should have an ambulatory blood pressure measurement. Savings of about ten million pounds in five years are promised. But what is the cost?

We can use the QOF data to work this out. As the PP1 indicator applies to all newly diagnosed hypertensives then the denominator is a good indicator of how many have been diagnosed in the previous year. (Acutally it underestimates buy up to 8% but I will let that pass for just now.) The total of the PP1 denominator over the UK in 2009/10 is 278,012

We can buy an ambulatory blood pressure machine. If we pick a decent supplier - I promise I am not on commission here - the cheapest today is £1350 including VAT.

As they go on one day and come off the next these could be used four times a week in most practices - 208 times a year.

Lets do a little bit of maths - 278012 patients per year divided by 208 slots (lets assume perfect useage) needs 1337 machines. At total cost of £1,804,404.

Of course if use is less than perfect - and to operate at all there will have to be some free slots - then the cost will be more. Possibly two to three times as much. This is a big upfront capital cost. Recurring costs will need to be added on as well as replacement costs. I would imagine a machine is going to start to look pretty shabby after 208 uses!

1 comment:

Dr J Bell said...

Hi Gavin.

I have been using a 24hr BP machine for 8 years. The machine still works perfectly, the problem is with the cuffs, they tend to develop a leak. replacement cuff just over £100. The rechargable batteries have been replaced this year as well.

Granted I don't use the machine 4 times per week, more like once every 2 weeks.

Practice size 6300.

Our CCG has purchased a new machine for all practices locally. Presumably there was a bulk discount. Now we have 2 machines to play with !