Table 3.
Disposition data and team opinion regarding likely standard care pathway and cost impact data
| Activity | Number | % | |
| Total patients seen by PRU | 1924 | 100 | |
| Managed in community | 1289 | 67.0 | |
| Referred to hospital | 597 | 31.0 | |
| Death at scene | 38 | 2.0 | |
| Patients who were managed in community | 1289 | 100 | |
| Managed in community with follow-up | 561 | 43.5 | |
| Managed in community without follow-up | 728 | 56.5 | |
| Communication with general practitioner | 245 | 19.0 | |
| Patients who were referred to hospital | 597 | 100 | |
| Referral direct to specialist team | 169 | 28.3 | |
| Conveyance by PRU | 115 | 19.3 | |
| Conveyance by LAS | 424 | 71.0 | |
| Unspecified conveyance (incl patient’s own) | 58 | 9.7 | |
| Likelihood of conveyance if PRU had not been dispatched | 1289 | 100 | |
| Likely | 945 | 73.3 | |
| Unsure | 140 | 10.9 | |
| Unlikely | 204 | 15.8 | |
| Likelihood of admission if had otherwise been conveyed | 1289 | 100 | |
| Likely | 126 | 9.8 | |
| Possibly | 179 | 13.9 | |
| Unlikely | 984 | 76.3 | |
| Cost of PRU activity | Unit cost (£) | Number | Total cost (£) |
| Reduction in LAS activity | |||
| Presumed LAS activity with a no PRU model | |||
| See and treat or refer | £192 | 369 | £70 848 |
| See, treat and convey | £252 | 1555 | £391 860 |
| Total cost | 1924 | £462 708 | |
| Cost of LAS involvement in current PRU model | |||
| See, treat and refer (i.e crew request) | £192 | 393 | £75 456 |
| See, treat and convey | £252 | 459 | £115 668 |
| Total cost | 852 | £191 124 | |
| Net benefit of PRU model versus no PRU model | £271 584 (a) | ||
| Reduction in hospital activity | |||
| ED attendances (patients deemed likely to have been otherwise conveyed to ED) | £160 | 945 | £151 200 |
| Nightly cost local non-elective inpatient bed (source: Barts Health NHS Trust Business Intelligence Unit) | £550 | 126 patients (868 bed days) |
£477 400 |
| Net benefit of PRU model to acute trusts versus no PRU model | £628 600 (b) | ||
| PRU operational costs | |||
| WTE PRU fellow posts (registrar) | £39 250 | 5×0.5 WTE | £196 250 |
| Consultant sessions (PAs) | £12 000 | 6 | £72 000 |
| LAS staffing enhancement | – | – | £60 000 |
| Non-recurrent costs (equipment, IT, expendables) | – | – | £10 000 |
| Rapid response vehicle lease | £16 160 | 1 | £16 160 |
| Managerial support | – | – | £15 667 |
| Total operational costs of PRU | £370 077 (c) | ||
| Overall net benefit ((a+b)–c) | £530 107 | ||
Expressed as n (%) unless otherwise stated.
IT, information technology; PA, programmed activities; PRU, Physician Response Unit; WTE, whole time equivalent.