Module 9: Planning Services, Costs & Funding Care

Hospital service planning connects patient needs with the staff, facilities and funding required to provide care. Medical Superintendents need to understand demand, identify limits in available capacity, assess costs and explain how services will be sustained.

This module covers service planning, patient flow, hospital costing and healthcare funding in Punjab, Pakistan. The lectures use simple explanations, worked calculations, practical hospital examples and cited official sources. Punjab requirements are distinguished from international planning and costing methods, and all illustrative figures are clearly identified.

This lecture explains how to turn a service problem into a clear proposal for decision. It begins with patient need and fair access, then examines alternative solutions, resource requirements, approval routes and measures of success.

Topics covered:

• Distinguishing health need, demand and services actually used.
• Connecting the hospital’s mission with strategic and operational plans.
• Comparing service options and setting fair priorities.
• Planning the complete patient pathway and supporting resources.
• Understanding PHC planning expectations and identifying relevant development-planning procedures.
• Preparing a service proposal with responsibilities, risks and review measures.

Practical focus: Preparing a service-planning brief that explains the need, compares options and identifies the decision required.

This lecture explains how to measure incoming work, assess usable capacity and identify where patients experience delays. It shows why installed beds, available staff and purchased equipment do not automatically represent a functioning service.

Topics covered:

• Counting patients, visits, admissions and procedures consistently.
• Calculating changes in waiting lists and assessing waiting times.
• Understanding bed occupancy and average length of stay.
• Estimating clinic capacity using clear assumptions.
• Identifying constraints in theatres, diagnostics and supporting services.
• Reviewing staffing, equipment readiness and daily service interruptions.

Practical focus: Preparing a service dashboard, a checked capacity estimate and an action plan for one patient pathway.

This lecture explains how to calculate the resources used by a hospital service and interpret the resulting cost figures. Worked examples demonstrate staff-time allocation, stock consumption, shared costs, equipment use and average cost per completed service.

Topics covered:

• Distinguishing resource costs, cash payments, tariffs and reimbursement.
• Understanding fixed, variable, direct and indirect costs.
• Allocating shared costs using a stated and reasonable method.
• Matching the cost calculation to the correct activity count.
• Separating average, incremental and avoidable costs.
• Testing assumptions and checking whether a claimed saving actually reduces spending.

Practical focus: Building a service cost sheet and explaining its calculations, assumptions and limitations.

This lecture explains how to connect service commitments with lawful and reliable funding. It distinguishes approved funding, expected income and cash actually received, and examines the continuing costs that can follow a new service or donated asset.

Topics covered:

• Mapping funding sources, restrictions and approval requirements.
• Understanding healthcare purchasing and provider payment methods.
• Checking scheme terms and reconciling claims with payments.
• Preparing cash forecasts and identifying funding gaps.
• Assessing the running costs of equipment, donations and service expansion.
• Distinguishing cost-effectiveness from budget impact and affordability.
• Protecting patient access when resources are constrained.

Practical focus: Preparing a three-year funding plan, a monthly cash forecast and a decision paper identifying unresolved gaps.