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Healthcare Professionals

Patient Level Information and Costing Systems (PLICS)

Background

Cost data is recorded and reported by NHS trusts and NHS foundation trusts under NHS Improvement (Monitor) requirements for the provider licence. This information has a variety of users – for example:

  • Trusts and commissioners use reference costs to manage their costs, agree local contracts and plan future services
  • NHS Improvement uses reference cost as the basis for pricing, including the national tariff;
  • Cost data supports a wide variety of cross-sectoral work to improve clinical outcomes and efficiency, including the work on operational productivity led by Lord Carter and benchmarking trusts to identify unwarranted cost variation.

The processes for submitting reference costs – and their accuracy – vary considerably between trusts. Between 2013 and 2015, audits commissioned by NHS Improvement found that over 50% of acute submissions were materially inaccurate. More recent audits suggest the quality of reference costs submitted by acute trusts has improved, and reference costs remain a key source of data used both within trusts and externally.

Reference cost data

Reference costs show how NHS providers spent money to provide healthcare to patients. They have been collected for every financial year since 1997/98.

Reference costs are used by trusts to understand efficiency, as well as for the Model Hospital, the getting it right first time (GIRFT) programme and national tariff prices. They are one of the richest sources of data about NHS finances.

To support the sustainable delivery of high quality patient care as outlined in the Five Year Forward View, providers need to fully understand their current models of care and what the impact would be of moving to a new way of delivering services.

Cost is an important factor in evaluating how effectively and efficiently you're delivering care to patients. Having accurate, consistent, patient-level cost information will help you to:

  • Make the best possible use of resources;
  • Evaluate clinical practice;
  • Compare different ways of working.

NHS Improvement previously consultedon their proposals to improve the costing of NHS services. This consultation document proposed:

  • A mandatory requirement (from 2018/19) for NHS trusts and NHS foundation trusts to record and report patient-level costs for acute activity in line with the Healthcare Costing Standards for England (the Standards);
  • To support the transition from reference costs to patient-level costs, NHS Improvement propose dual running of reference cost and patient-level cost collections for up to two years (2018/19 and 2019/20).

A published decision will be available in early 2018.

Patient Level Information and Costing Systems 2017 Collection

NHS Improvement's Costing Transformation Programme (CTP) was established to implement Patient Level Information and Costing Systems (PLICS) across Acute, Mental Health, Ambulance and Community providers.

The Acute collection in 2017 is made up of data from 78 early implementer Acute Trusts that have been using PLIC Systems for several years (Appendix list).PLICS collection guidance is to be used by these acute sector early implementers in submitting their 2016/17 cost data.

The data will enable the testing and review of new standards that are being developed by NHS Improvement in relation to patient level costing.

NHS Improvement has requested that NHS Digital establishes and operates a system to collect patient-level costing information under section 255 of the Health and Social Care Act 2012.

Health Episode Statistics (HES) provides one half of the cost collection data NHS Improvement will receive from NHS Digital (NHS admitted patient care (APC), outpatient appointments and A&E attendances in England). The other half of the collection data is defined in the submission extract specification which describes the fields providers are to submit to NHS Digital in the summer 2017 collection.

The submissions will be sent into NHS Digital in XML format. Further information about the format of the XML files is available from NHS Improvement 2016/17 Patient Level Information and Costing Systems (PLICS) cost collection guidance file specifications.

This is a single annual collection exercise from each of the 78 Trusts. Collections are scheduled to take place from July to December 2017. Trusts should be aware of their individual collection dates within the overall schedule following previous communications from NHS Improvement. The collection schedule has been agreed between NHS Digital and NHS Improvement with Trust's input as part of its development.

Collection resources and activities

Resources are a collection of costs used to deliver an activity. The costs within a resource may have different information sources and cost drivers. Once these costs have been calculated they can be aggregated to whatever level the resources have been set at, and you can be confident the resource unit cost is accurate because it is underpinned by this costing process.

Activities are the ‘things’ the provider does, such as a procedure in theatre or a pathology test. Together resources and activities form a two-dimensional view of what costs have been incurred to deliver what activity.

Departments should work with their informatics and costing departments to understand the different types of activity in these collections to ensure costs are allocated correctly to activity, and that activity is reported correctly in their patient-level reporting dashboard. For example;outpatient department costs are allocated to all activity that takes place in the department, this incorporates the main procedures performed (including non- face to face activity), teaching, training, Cancer MDTs, clinics times, equipment, theatre minutes etc.

Take care to identify any ‘hidden’ activity within your department. This is activity that takes place but is not recorded on your organisation’s main systems such as PAS.

For example, a department may report its admitted patient care activity on PAS but not its community activity. If this is the case, you should work with the informatics department and the department responsible for the data to obtain a feed containing 100% of the activity undertaken by the department.

Org code

Organisation name

Org code

Organisation name

REM

Aintree University Hospital NHS Foundation Trust

RBZ

Northern Devon Healthcare NHS Trust

RCF

Airedale NHS Foundation Trust

RJL

Northern Lincolnshire and Goole NHS Foundation Trust

RBS

Alder Hey Children's NHS Foundation Trust

RTF

Northumbria Healthcare NHS Foundation Trust

RTK

Ashford and St Peter's Hospitals NHS Foundation Trust

RX1

Nottingham University Hospitals NHS Trust

RF4

Barking, Havering and Redbridge University Hospitals NHS Trust

RTH

Oxford University Hospitals NHS Foundation Trust

RFF

Barnsley Hospital NHS Foundation Trust

RGM

Papworth Hospital NHS Foundation Trust

R1H

Barts Health NHS Trust

RW6

Pennine Acute Hospitals NHS Trust

RDD

Basildon and Thurrock University Hospitals NHS Foundation Trust

RK9

Plymouth Hospitals NHS Trust

RC1

Bedford Hospital NHS Trust

RD3

Poole Hospital NHS Foundation Trust

RQ3

Birmingham Women’s and Children's Hospital NHS Foundation Trust

RHU

Portsmouth Hospitals NHS Trust

RXL

Blackpool Teaching Hospitals NHS Foundation Trust

RPC

Queen Victoria Hospital NHS Foundation Trust

RMC

Bolton NHS Foundation Trust

RHW

Royal Berkshire NHS Foundation Trust

RAE

Bradford Teaching Hospitals NHS Foundation Trust

RT3

Royal Brompton & Harefield NHS Foundation Trust

RXH

Brighton and Sussex University Hospitals NHS Trust

REF

Royal Cornwall Hospitals NHS Trust

RXQ

Buckinghamshire Healthcare NHS Trust

RH8

Royal Devon and Exeter NHS Foundation Trust

RJF

Burton Hospitals NHS Foundation Trust

RAL

Royal Free London NHS Foundation Trust

RWY

Calderdale and Huddersfield NHS Foundation Trust

RQ6

Royal Liverpool and Broadgreen University Hospitals NHS Trust

RGT

Cambridge University Hospitals NHS Foundation Trust

RAN

Royal National Orthopaedic Hospital NHS Trust

RW3

Central Manchester University Hospitals NHS Foundation Trust

RA2

Royal Surrey County Hospital NHS Foundation Trust

RQM

Chelsea and Westminster Hospital NHS Foundation Trust

RD1

Royal United Hospitals Bath NHS Foundation Trust

RFS

Chesterfield Royal Hospital NHS Foundation Trust

RM3

Salford Royal NHS Foundation Trust

RLN

City Hospitals Sunderland NHS Foundation Trust

RNZ

Salisbury NHS Foundation Trust

RDE

Colchester Hospital University NHS Foundation Trust

RXK

Sandwell and West Birmingham Hospitals NHS Trust

RJR

Countess Of Chester Hospital NHS Foundation Trust

RCU

Sheffield Children's NHS Foundation Trust

RXP

County Durham and Darlington NHS Foundation Trust

RHQ

Sheffield Teaching Hospitals NHS Foundation Trust

RJ6

Croydon Health Services NHS Trust

RK5

Sherwood Forest Hospitals NHS Foundation Trust

RN7

Dartford and Gravesham NHS Trust

RXW

Shrewsbury and Telford Hospital NHS Trust

RTG

Derby Teaching Hospitals NHS Foundation Trust

RTR

South Tees Hospitals NHS Foundation Trust

RP5

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

RE9

South Tyneside NHS Foundation Trust

RBD

Dorset County Hospital NHS Foundation Trust

RJC

South Warwickshire NHS Foundation Trust

RWH

East and North Hertfordshire NHS Trust

RAJ

Southend University Hospital NHS Foundation Trust

RJN

East Cheshire NHS Trust

RVY

Southport and Ormskirk Hospital NHS Trust

RVV

East Kent Hospitals University NHS Foundation Trust

RJ7

St George's University Hospitals NHS Foundation Trust

RXR

East Lancashire Hospitals NHS Trust

RBN

St Helens and Knowsley Hospital Services NHS Trust

RXC

East Sussex Healthcare NHS Trust

RWJ

Stockport NHS Foundation Trust

RVR

Epsom and St Helier University Hospitals NHS Trust

RTP

Surrey and Sussex Healthcare NHS Trust

RDU

Frimley Health NHS Foundation Trust

RMP

Tameside and Glossop Integrated Care NHS Foundation Trust

RR7

Gateshead Health NHS Foundation Trust

RBA

Taunton and Somerset NHS Foundation Trust

RLT

George Eliot Hospital NHS Trust

RBV

The Christie NHS Foundation Trust

RTE

Gloucestershire Hospitals NHS Foundation Trust

REN

The Clatterbridge Cancer Centre NHS Foundation Trust

RP4

Great Ormond Street Hospital for Children NHS Foundation Trust

RNA

The Dudley Group NHS Foundation Trust

RN3

Great Western Hospitals NHS Foundation Trust

RAS

The Hillingdon Hospitals NHS Foundation Trust

RJ1

Guy's and St Thomas' NHS Foundation Trust

RTD

The Newcastle Upon Tyne Hospitals NHS Foundation Trust

RN5

Hampshire Hospitals NHS Foundation Trust

RQW

The Princess Alexandra Hospital NHS Trust

RCD

Harrogate and District NHS Foundation Trust

RCX

The Queen Elizabeth Hospital, King's Lynn, NHS Foundation Trust

RR1

Heart Of England NHS Foundation Trust

RL1

The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust

RQX

Homerton University Hospital NHS Foundation Trust

RFR

The Rotherham NHS Foundation Trust

RWA

Hull and East Yorkshire Hospitals NHS Trust

RDZ

The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust

RYJ

Imperial College Healthcare NHS Trust

RPY

The Royal Marsden NHS Foundation Trust

RGQ

Ipswich Hospital NHS Trust

RRJ

The Royal Orthopaedic Hospital NHS Foundation Trust

R1F

Isle of Wight NHS Trust

RL4

The Royal Wolverhampton NHS Trust

RGP

James Paget University Hospitals NHS Foundation Trust

RET

The Walton Centre NHS Foundation Trust

RNQ

Kettering General Hospital NHS Foundation Trust

RKE

The Whittington Hospital NHS Trust

RJZ

King's College Hospital NHS Foundation Trust

RA9

Torbay and South Devon NHS Foundation Trust

RAX

Kingston Hospital NHS Foundation Trust

RWD

United Lincolnshire Hospitals NHS Trust

RXN

Lancashire Teaching Hospitals NHS Foundation Trust

RRV

University College London Hospitals NHS Foundation Trust

RR8

Leeds Teaching Hospitals NHS Trust

RM2

University Hospital of South Manchester NHS Foundation Trust

RJ2

Lewisham and Greenwich NHS Trust

RHM

University Hospital Southampton NHS Foundation Trust

RBQ

Liverpool Heart and Chest Hospital NHS Foundation Trust

RRK

University Hospitals Birmingham NHS Foundation Trust

REP

Liverpool Women's NHS Foundation Trust

RA7

University Hospitals Bristol NHS Foundation Trust

R1K

London North West Healthcare NHS Trust

RKB

University Hospitals Coventry and Warwickshire NHS Trust

RC9

Luton and Dunstable University Hospital NHS Foundation Trust

RWE

University Hospitals of Leicester NHS Trust

RWF

Maidstone and Tunbridge Wells NHS Trust

RTX

University Hospitals of Morecambe Bay NHS Foundation Trust

RPA

Medway NHS Foundation Trust

RJE

University Hospitals of North Midlands NHS Trust

RBT

Mid Cheshire Hospitals NHS Foundation Trust

RBK

Walsall Healthcare NHS Trust

RQ8

Mid Essex Hospital Services NHS Trust

RWW

Warrington and Halton Hospitals NHS Foundation Trust

RXF

Mid Yorkshire Hospitals NHS Trust

RWG

West Hertfordshire Hospitals NHS Trust

RD8

Milton Keynes University Hospital NHS Foundation Trust

RGR

West Suffolk NHS Foundation Trust

RP6

Moorfields Eye Hospital NHS Foundation Trust

RYR

Western Sussex Hospitals NHS Foundation Trust

RM1

Norfolk and Norwich University Hospitals NHS Foundation Trust

RA3

Weston Area Health NHS Trust

RVJ

North Bristol NHS Trust

RBL

Wirral University Teaching Hospital NHS Foundation Trust

RNL

North Cumbria University Hospitals NHS Trust

RWP

Worcestershire Acute Hospitals NHS Trust

RAP

North Middlesex University Hospital NHS Trust

RRF

Wrightington, Wigan and Leigh NHS Foundation Trust

RVW

North Tees and Hartlepool NHS Foundation Trust

RLQ

Wye Valley NHS Trust

RGN

North West Anglia NHS Foundation Trust

RA4

Yeovil District Hospital NHS Foundation Trust

RNS

Northampton General Hospital NHS Trust

RCB

York Teaching Hospital NHS Foundation Trust

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