You have been made aware of a new PCR test X. It seems to work very well, and diagnoses disease Y with high sensitivity and specificity, and with a decrease in turnaround time compared to what you have been doing previously. You are confident that it will decrease length of admission, reduce unnecessary investigations and will save your local hospital a lot of money.

It’s not even that expensive. Sure it costs more than your old style test but surely that will be compensated for by the above….

There are certainly plenty of Test Xs out there these days. A new one seems to come on the market every other week.

So why can it be so difficult to get funding for Test X?

A large part of the reason is that the savings made may occur in a different budget to the one where the extra costs are incurred, even if the central funder for both budgets is the same body. In other words the funding is siloed.

Funding silos are of course not unique to microbiology, laboratory medicine, or even healthcare. They are a ubiquitous problem, but can be frustrating nevertheless. And silos, as we are aware, are notoriously difficult to break down. They are much more of a problem with the system, rather than any individuals involved. Silos are the end result of society’s inability to look beyond the immediate environment and I believe they are culturally engrained in all of us.

If I knew of an easy way to break down the funding silos and get test x funded, I would divulge them, but I don’t think there are any easy solutions. Persistence is key, backing your argument up with as much evidence as possible, focusing on clinical risk, and extending empathy with your funder’s predicament are all good starting points, but does not guarantee success!

Michael

Silos of course do not just apply to funding but can even occur in departments in a laboratory! It is always worthwhile reviewing the good things that happen in your department and considering whether they can apply to other departments as well. Click here for a nice article on silos (about a 5 min read)