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 consulted on 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 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