COST CONTROL OF OUT-OF-HOURS LABORATORY SERVICES IN DISTRICT GENERAL HOSPITALS

Aims-To survey methods for cost control of out-of-hours laboratory ser vices in district general hospitals in England and Wales. Methods-A qu estionnaire was distributed to 66 district general hospital laboratori es in England and Wales. Results-The response rate was 61%. Most labor atories for which budgetary information was provided had on-call costs ranging between 10-21% of staff costs. Ninety five per cent of respon dents had attempted to reduce workload by the use of various strategie s. Seventy two per cent of responding laboratories had negotiated a wi de variety of on-call agreements outside Whitley Council arrangements. Seventy two per cent were not satisfied with their on-call arrangemen ts, the main desired objective being the introduction of the extended working day. Conclusions-From this study it seems that Whitley Council agreements for out-of-hours work are no longer appropriate for the av erage district general hospital laboratory. Workload reduction strateg ies should include the use of a limited list, audit of the use of the on-call service, and continued education of medical staff. Considerati on may also be given to the introduction of fixed payments, extension of the working day, increased multidisciplinary on-call and increased bedside testing.