The aim of the financial system 'Payment by Results' is to provide a transparent, rules based system for paying trusts. The system pays for activity not results e.g. for number of operations done not lives saved. The aim is to reward efficiency, support patient choice and diversity and encourage activity for sustainable waiting time reductions. Payment will be linked to activity and adjusted for casemix. The central idea is that the NHS will be a fixed price for a particular operation of treatment wherever the care is provided (i.e same price for all hospitals) This system aims to ensure a fair and consistent basis for hospital funding rather than being reliant principally on historic budgets and the negotiating skills of individual managers.

11 What is the significance of renal disease with respect to anaemia, if any?

12 Can anaemia be a differentiating point between muscle wasting and cachexia owing to another systemic disorder?

13 Anaemia of chronic disease does not respond to iron therapy, but there are trials studying the use of iron and erythropoietin (EPO). Could you tell me where to find more detailed information about these trials, and whether there have since been any further developments?

14 Is the deoxyuridine test helpful?

15 The Schilling test is very rarely performed. Why is this?

16 There is no extramedullary haematopoiesis in aplastic anaemia, why?

17 Why is the anaemia in aplastic anaemia, macrocytic?

18 Is vitamin B12 absorbed passively from the jejunum?

19 What role does 'R' binder play in the absorption of vitamin B12?

20 In pernicious anaemia, investigation of the serum shows an elevated level of gastrin. Why is it so?