In these constrained fiscal circumstances, it is all the more important to think about treating our patients effectively and efficiently.  Money saved helps us look after patients.  Please remember the high cost of many medical devices and disposables, and bear the following in mind:

  • Prescribe morphine PCA (as opposed to fentanyl) as first line for patients with normal renal function.
  • Use metoclopramide as first line prokinetic.  Erythromycin is phantasmagorically expensive.
  • When changing infusions (e.g. from a fentanyl to a morphine PCA), consider using up the current bag if clinically appropriate.
  • Only open kit you are definitely going to use.
  • Think before opening a pack.  Are you going to use most of the items in it, or would it be better to assemble things separately?
  • For tracheostomies, we have separate drapes, gowns and disposable instruments.  Do you really need to use a CVC pack?
  • If you drop a CVC wire, there are spare ones available.
  • Equipment costs a small fortune to repair.  Especially on transfers, make sure it is secure and inside the bed.
  • If you are interested in doing an ‘efficiency’ QI project, speak to Dr Peter Shirley or Waqar Iqbal.
  • The Capital Hospitals Company, who own the building, made a paltry £2 million profit in 2017, compared to the £5 million the year before.  At least we’re looking after the bankers.