Finance and Governance in Health and Social Care Assignment
Assignment Detail:-
- Number of Words: 3000+Calcuations
Assessed Learning Outcomes
LO2: Analyse and evaluate financial statements, budgets, and forecasts, and apply financial management principles to healthcare organisations to make informed and ethical financial decisions.
LO4: Analyse financial and governance challenges in healthcare organisations and formulate solutions for overcoming these challenges.
ASSIGNMENT QUESTION:
Please read the following scenario:
You have been appointed as a financial consultant to an NHS Trust Hospital in London. The hospital is planning to launch a bariatric (weight loss) surgery unit offering procedures like gastric bypass and gastric sleeve surgeries for both NHS and private patients. You have been asked to consolidate and analyse the plan, perform financial forecasting and suggest innovative strategies to optimise costs and maximise revenue while considering ethical and public concerns. Your report should include an appraisal of the proposed project, effective ways of obtaining funding (if necessary) and a recommendation to the hospital.
Background
According to the King’s Fund briefing (2021) on “Tackling Obesity”, obesity rates in England are high and rising and weight loss surgery is becoming increasingly popular. The frequency and pace of increase are not evenly distributed throughout society and there is a significant systemic link between obesity and deprivation. Obesity rates are also greater in women than men, as well as in several ethnic minority groups as compared to the white British population. Recent governments have attempted a fragmented approach to combating obesity and while some specific initiatives have been helpful, this method falls short of the cross-cutting population health approach that is required.
The following key messages are shared in the briefing (p.1).
- “In 2019, 64 per cent of adults in England were overweight, with 28 per cent being obese and 3 per cent morbidly obese (NHS Digital 2020a). Obesity is a significant health risk and is associated with an increased risk of diseases including diabetes, heart disease and some cancers.
- There has been a significant increase in obesity in the most deprived communities in England in recent years, leading to a widening gap between the most and least deprived
- Childhood obesity has followed a similar For children in year six there was a 13- percentage-point gap in obesity rates between the most and least deprived children in 2019, up by 5 percentage points since 2006 (NHS Digital 2020b).
- The causes of obesity are many and The most important risk factor is an unhealthy diet, while physical inactivity also plays a role. People in deprived areas often face significant barriers to accessing affordable, healthy food and regular exercise (Public Health England 2017).
- In 2019/20 there were more than 1 million hospital admissions linked to obesity in England, an increase of 17 per cent on the previous year. Rising rates of obesity translate to increasing costs for the In 2014/15 the NHS spent £6.1 billion on treating obesity- related ill health, this is forecast to rise to £9.7 billion per year by 2050 (NHS Digital 2021; Public Health England 2017).
- Differences in obesity rates translate to worse health outcomes for people in more deprived areas and contribute to health inequalities. Rates of obesity-related hospital admissions in the most deprived areas of England are 4 times greater than in the least deprived areas (NHS Digital 2021; Ministry of Housing, Communities and Local Government 2019).”
After reviewing the report, the CEO of the NHS Trust Hospital engaged with the C-level management team and suggested the following preliminary budget and cost plan for the planned private weight loss surgery unit offering procedures like gastric bypass and gastric sleeve surgeries. While these surgeries can significantly improve health outcomes, they are expensive and often seen as controversial when offered through public healthcare systems. There are concerns about prioritising resources, accessibility and the perception of promoting surgical solutions over lifestyle changes.
Checkout Now: Health and Social Care Dissertation Topics
Currently, to qualify for the NHS-funded weight loss surgery, individuals must be severely obese, with a BMI of more than 40 or have a BMI between 35 and 40 with two or more obesity- related chronic diseases. They will also need to agree to lifestyle and diet changes and regular check-ups after surgery. NHS-funded weight loss surgery requires previous unsuccessful or unsustainable attempts at weight loss through diet and physical activity.
The hospital plans to initiate the following setup: A medical building will be leased for a five- year term, with an initial payment of £1 million will be paid immediately and £1 million per year for the next five years. The unit will purchase numerous pieces of equipment as an initial set- up to deliver high-quality treatment, which will cost £25 million. The hospital seeks to treat 500 NHS and 250 private patients a year.
The NHS Foundation Trust will cover the initial cost out of pocket, but in the succeeding five years will also receive £115 million in total from the DHSC will be distributed equally over the period.
Data File
Initial cost:
Initial lease payment and equipment costs: £26 million (£1 million + 25 million, respectively)
Ongoing operational costs Leasing: £1 million per year Insurance: £0.1 million per year Utilities: £0.5 million per year Consumables: £1 million per year Maintenance: £0.3 million per year Medical supply: £1.3 million per year
Data management (security/privacy) and IT Infrastructure: £0.6 million per year RsD, collaboration and partnership costs: £1 million per year
Training and education costs: £1.2 million per year Patient and public education: £0.8 million per year Other running costs: £0.6 million per year
Treatment costs
Average cost per NHS patient: £8,000 Average cost per private patient: £12,000
Estimated staffing costs:
Surgeons and medical staff: £3 million per year Nurses and support staff: £2 million per year
Administrative and management staff: £1 million per year
Private patient revenues
Total treatment revenues (250 patients): £4 million
The required rate of return: 3.5% Inflation: 0%
Assignment Task
You are required to prepare a report, using the information provided above covering the following areas:
- Create a cash flow model to predict the effects of the proposal over the next five Critically evaluate its financial feasibility by applying investment appraisal techniques. (30 marks)
- Revise the proposal in (a) and provide innovative ways to reduce expenses and improve financial Identify the type of budgeting that would be suitable for the proposal and explain why. (20 marks)
- Discuss traditional sources of financing and explain how they differ from NHS funding. (20 marks)
- Identify and critically analyse the three key measures that are highlighted to tackle obesity, using the white paper Critically evaluate the potential impact of the measures on patient care. (20 marks)
- Report structure and (10 marks)
ASSIGNMENT GUIDANCE
In writing your report you are expected to use theoretical tools that you have studied during the course and from your research and make reference to credible evidence. The format for a report is available on the VLE.
At least 8 independently researched academic sources from the ARU library are expected.
ASSIGNMENT CORE READING
Atrill, P. s McLaney, E. (2022). Accounting and Finance for Non-Specialists, 12th ed. Pearson.
Bandy, Gary (2024). Financial Management and Accounting in the Public Sector, 3rd edition, Routledge, London. Available through Kortext and/or ARU Library.
Brigham, E.F. and Houston, J.F., (2021). Fundamentals of financial management: Concise. Cengage Learning.
Bragg, S. M. (2017). Budgeting: A Comprehensive Guide, 4th ed. Accounting Tools Incorporated.
Dyson, J.R. and Franklin, E. (2020) Accounting for Non-Accounting Students, 10th edition, Pearson
Frost, S. M. (2024). Financial Accounting and Reporting for Non-Accounting Students (1st ed.). Kogan Page.
HFMA Introductory Guide to NHS Finance (2023). HFMA
Kimmel, P. D., Weygandt, J. J. s Mitchell, J. E. (2021). Financial Accounting: Tools for Business Decision Making, 10th ed. Wiley
