Impact Of Closing Accident And Emergency Service On Ipsborough Hospitals And Pelawton Hospital

Location of the client hospitals

This report contains the discussion regarding the closer of some of the services and their impact on the operation as well as the financial position of the company. In the given case the two hospitals Ipsborough Hospitals and pelawton Hospital are taken in to consideration. These are the popular hospitals and they are providing extraordinary medical services to the patients. In the given case New Life Trust is the surgical and medical service provider of these the hospitals. In addition to that the board of directors of the New Life Trust is requested to provide a report about the impact on the issue if the company decides to not to carry on the accident and emergency services to the client hospital (Connor 2015). As the accident and emergency service is one of the important and key dominator service in the hospital industry an in-depth analysis of fact of such closer is requested to provide in the report. The report will hold the discussion of the financial impact, critical issues, benefits and loss in closer and other important factors.

The current distance between the above considered hospitals is that Ipsborough Hospitals and Pelawton is 10 miles, which is very high. Therefore the impact of the one hospital will not influence the other one. In addition to that the other hospitals are situated in the other places of the city. The nearest hospital to the Ipsborough Hospitals is Crumpton which is approximately 5 miles from the hospital in the east. The other nearest hospital to Ipsborough Hospitals is Plamsfort which is situated 15 miles in the east. The Curmption is far away by 12 miles from the Pelawton (Broom and Turner 2015). Colton is the other competitive hospital situated 12 miles away from the Pelawton. The geographical structure of the hospital is highly encourage able, and a more important issue in the contest is that both the hospitals utilises substantial benefits as they are not contradictory and the other competitors are far away from the location. Therefore the hospital serves a lot numbers of patients because of the easy and short convenience.

The New Life Trust serves all the medical and surgical facilities to its client. Form the operations, medical check up to the treatment of accident and emergency service. The overall impact of the Service provider to the Ipsborough Hospitals and Pelawton hospital are quitter influential (Hancock 2016).

The board of directors recommended that they are willing to close the accident and Emergency service from the New Life Trust who are the medical and surgical service provider. In the given case both the hospitals are operating a quality accident and emergency departments. There are only one ambulance service providers existing in the market, New Life Trust. All the connectivity to the hospital are good because of the road conditions (Settle 2016). The prime issue is that there are specific accident and emergency department existing both hospital and they are evaluated and the results and their performance is quite good. The departments are utilising the 85% capacity of the working but it can be increased by the felicitation and expending. As there are existing ambulance that is provided by the hospitals for the onsite support to the accidents and the emergencies (Kuhlmann et al. 2015).

Services provided

There are several issues that are to be examined and discussed here under.

Transfer of the affected patients in a medical emergency situations is the ultimate objective of the mission of Emergency medical Service (EMS). If the hospital decided to close the emergency and accident transportation service form the New Life Trust then there are some important financial factors which are required to be discussed  that are here under.

Cost:

In present it is assumed that the New Life Trust is providing the service on commission basis which means that the company is paying the service charge only at receiving the service. In London the average cost of ambulance service cost approximately 7.81 euros. If the service are required to be provided at the home then the clinician cost is 64.59 euros and in case there is a need of transporting the patient to the hospital is overall cost 254.57 euros (Mukund et al. 2015). If the company decided to carry on their own ambulance for accident and emergency service they needs to invest a huge money for acquiring new ambulance vehicle, support staffs, the doctors and the nurses. It is surely that if the hospital directly involved in the operations they will able to provide the service in a cheaper rate and the cost of the service will also become low (Pappas and Welton 2015).

Controllability:

In the current situation the hospitals are operating at 85% of the performance. But in the normal sense the number or pick up and adoption of the accident and emergency service can to be reliably ascertainable (Reid 2016). Though the hospital might have developed a good idea of average number of patients that take ambulance service in a day but it is also not justifiable in the context of the industry. Both the hospital are situated in a differentiated areas. In case of an emergency when the ambulance is not available by the hospital to reach the patients in that case the other ambulance service will avail the opportunity to grab the competition (Cunningham et al. 2015). Suppose the hospital has the power to serve 15 patients at a time. In case of a serious emergency all the ambulance is engaged then they have to ask the other ambulance service provider for the help. This will cost high.

Investment:

The current performance is evaluated that the hospitals are operating in 85% of the total capacity. This is high, if the hospital adopt the proposed plan then it needs to increase the number of ambulance, support staff, clinician, doctors and others.

Proposed cost of investment
Particulars	Number	Amount	Total
ambulance	5	250000	1250000
support staff	15	10000	150000
Clinician	5	15000	75000
Doctors	5	30000	150000
Total			1625000

Issues

The above figures are only the initial costs and all the cost are taken for a month of service except the Ambulance. The ambulance are taken as equipped.

Cost of operations:

The cost of operations mean the other cost that are directly or indirectly allocated with the services rendered. This means when the hospital triggers the operation of the propose plan it has to incur some continuing cost that are not directly related with the operation, such as electricity, maintains, in house support service, operational manger, accounting and book keeping and others. This are not significant on individual basis but substantial on the overall impact (Xu et al. 2015).

In slow down:

The price of the services are fixed and made on the cost of the services. In case the increased service is not felicitated then the hospital have to bear a huge cost for carrying on the service. As it cannot be ascertainable that how much patients will come for the service in some days the ambulance are not going to be used in that case the fixed cost are to be beard by the hospital (Arduino 2017).

The relevance of the financial analysis is the guiding tool to evaluate the performance and the decision making. The finical analysis will be conducted by comparing the benefits of the proposed plan and the current plan. In this comparison only the Fixed cost are to be taken for the decision making

Particulars	cost per month present	cost per month proposed	Total	Present annual	Proposed annual	total	variance present	variance proposed
Support staff	300000	150000	450000	3600000	1800000	5400000	0.666667	0.333333333
Clinical	150000	75000	225000	1800000	900000	2700000	0.666667	0.333333333
Doctors	300000	150000	450000	3600000	1800000	5400000	0.666667	0.333333333
Transportation	25000	12500	37500	300000	150000	450000	0.666667	0.333333333
Fuel	15000	5000	20000	180000	60000	240000	0.75	0.25
Electricity	1000	1000	2000	12000	12000	24000	0.5	0.5
Operational Manager	15000	5000	20000	180000	60000	240000	0.75	0.25
cleaning and maintains	10000	5000	15000	120000	60000	180000	0.666667	0.333333333
Repair of the ambulance	10000	5000	15000	120000	60000	180000	0.666667	0.333333333
Depreciation	18750	9375	28125	225000	112500	337500	0.666667	0.333333333
Others	1500	1000	2500	18000	12000	30000	0.6	0.4

In the proposed plan there are some influential issues that are to be taken in to consideration by the authorities and understanding the impact of this activates on the viability of the overall organisational performance. The board of directors needs to understand if the activities and the responsibilities of the organisation is lifted then the burden of operation will also be increased. Further the under stated issues are to be considered (Scheffler et al. 2018).

If the proposed plan is implemented then there will be huge investment and the operation cost are to be incurred by the hospitals. The risk is not only limited to the financial risk. The overall risk of the transportation and providing medical service to the accidental patients or for the emergency cases will increase the risk orientation (Scheffler et al. 2018).

If the proposed plan is implemented then the companies normal work flow may be hampered because the current utilisation of the accidents and emergency medical treatment resources are used up to 85% of the total capacity. Though it is considerable that it can be increased then it is keep in the mind that the performance or performing the basic services and activities will be increased. In addition to that the company has to take extra burden.

Direct Financial factor

In the concurrent policy if the transportation or ambulance service is provided by the New Life Trust, then in the case the hospital does not have to invest the precious time and resources as they will only pay only at the time of taking the service. Further the risk of shortage of the ambulance will not be entertained and in case of no use of the ambulance the hospital will not be suffered by a single penny (Baker et al. 2017). In addition to that the hospital may concentrate the other important activities for the betterment of the hospital and the services rendered to the patients.

In the boards proposed policy is implemented then in that case both the hospitals will enjoy a better income and self-controlled activities. In that case the hospitals will be able to support the quality service to the patients. Further the own set up will be more trust worthy. In case of emergency the hospitals will be pre-knowledge about the condition of the patients and make fast and effective solution and arrangements in the hospital and can treat the patient as soon as possible.

In addition to this the hospital has some other social responsibilities too. In the given case there are no hospital are nearby situated who are able to provide the accident and emergency care services if any one of the hospital fails to deliver that (Lawanson and Opeloyeru 2016). In case Ipsborough Hospital, if they are not contusing with the ambulance service for  the New Life Trust then it will not be as effective as there are other hospital nearby, Crumpton. But if the Pelawton discontinues the current plan then it may cause serious issues as there are no other hospital nearby (Casado and Younas 2015).

From the above discussion it is advisable to the board of directors that the current policy is good. The operations are being conducted mutually by the hospital and the new Life trust. In the case both the entities are enjoying a potential benefits and the risk factor is diversified. In addition to that the ROI or the return on investment is not adequate to select the proposed plan. The hospital have the ability to use the valuable resources in the other activities to felicitate the business and the quality service.

Conclusion:

From the above report various components and risk factors including the financial risk factors are revised, analysed and discussed and the relative and competitive suggestion is being provided to the Board of Directors for making a suitable decision regarding the proposed plan. The proposed plan is not Worthing the materiality of the fact therefore Ipsborough and Pelawton hospital is advised to carry on the current policy. And should work collaboratively with the New Life Trust.

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