I cannot contain it any longer – the deep-rooted accountant’s need to share numbers and costings with my new found colleagues.

Two things have stopped me doing it before now. First, I have been trying to work out the best way to share this exciting stuff with the clinicians and patients I have met so far. Most of them really can’t understand how an accountant gets their kicks. So I need to give some serious thought to how I can best deliver the big impact messages that will make them ‘wow’ quietly and then want to seize the power and opportunity these figures will give us in our redesign.

Second, and perhaps more interesting, is the time it is taking us to collect the figures. The cost of the acute stay in hospital is easy – well for commissioners it is – national tariff x volume of activity.

But then adding the cost of community nursing and therapists’ input, the cost of individually designed social care packages, preventative programmes across health and social care and prescribing to those who might be at risk of having a stroke and those who have already suffered one, you can see it’s going to be a bit more tricky.

Our local patient activity systems just don’t collect the data we need to make these costs pathway specific. The residual presence of block, and the emerging cost and volume, contracts for intermediate care and community services make it difficult to break down expenditure beyond these high level categories.

So, with the aid of some very smart and committed financial support from both health and social services, we are developing a ‘bottom-up’ model. This is the only way we will objectively prove what impact our redesign is having on the relationship between patient flows and costs. It will prove if we are providing better value for money and if we are truly targeting financial investment where it is needed. This is another area where I am keen to know if any of you have experiences you can share with Leicester.