2016/17 PLICS cost collection guidance - Improvement · 2020. 6. 18. · 4 | Acute > 2016/17 PLICS...

2016/17 PLICS cost collection guidance Acute

Updated March 2017

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Contents

1. Introduction …………………………………………………………………………………….. 4

1.1. Purpose of this guidance ……………………………………………………………………… 4

1.2. Main changes for 2016/17 ………………………………………………………………........ 4

1.3. Background …………………………………………………………………………………….. 5

2. Scope…………………………………………………………………………………………… 6

2.1. In scope………………………………………………………………………………………… 6

2.2. Out-of-scope services and reconciliation items…………………………………………….. 8

2.3. Role of NHS Digital and Hospital Episode Statistics ………………………………………. 10

3. Collection timetable ……………………………………………………………………………. 11

4. Applying the healthcare costing standards for England …………………………………… 12

5. Applying the reference costs grouper ………………………………………………………... 12

6. Treatment of specific costs and services/activities: additional guidance……..………….. 13

6.1. Well babies ……………………………………………………………………………………… 13

6.2. Unbundled services ……………………………………………………………………………. 13

6.3. Multidisciplinary team (MDT) meetings ……………………………………………………..… 15

6.4. Staff on long-term leave …………………………………………………..…………………….. 15

6.5. Sexual health, HIV services and other confidential services ……………………………….. 16

6.6. Excess bed days ………………………………………………………………………………... 16

6.7. Reporting requirements for mergers and acquisitions ……………………………………...... 16

6.8. Education and training costs …………………………………………………………………… 16

7. How we will use the collection data ………………………………………………………….. 17

8. Board approval and sign-off …………………………………………………………………... 18

9. Reconciliation tables …………………………………………………………………………… 18

9.1. Final audited accounts ………………………………………………………………………… 19

9.2. Cost group reconciliation ……………………………………………………………………... 19

9.3. Out-of-scope services and costs …………………………………………………………….. 20

9.4. Activity reconciliation ………………………………………………………………………….. 20

10. Collection extract files overview ……………………………………………………………... 20

10.1. File specification and data fields ………………………………………………………… 21

10.2. File batching process ………………………………………………………………………….. 22

10.3. Extract file name convention …………………………………………………………………. 23

10.4. Data validation …………………………………………………………………………………. 23

11. Collection resources and activities ………………………………………………………………. 24

12. Data submission …………………………………….. ………………………………………. 26

13. Costing assessment tool ……………………………………………………………….……. 28

4 | Acute > 2016/17 PLICS cost collection guidance, updated March 2017

1. Introduction

1.1. Purpose of this guidance

This guidance gives the technical specifications we are asking acute early implementers to

adhere to for a patient-level information and costing systems (PLICS) collection in summer

2017. We specify the fields we will collect and provide additional guidance to support the

consistent allocation of costs. This collection replaces the voluntary PLICS collection (cost

pools) that has been run for the last four years.

We cover:

the scope of the collection

collection extracts

the role of NHS Digital1

how will we use the data

how to report specific costs.

We do not cover the submission process, further guidance will be provided to participants in

due course.

1.2. Main changes for 2016/17

We have made changes to the 2015/16 PLICS cost collection to:

support the transition to a single cost collection as outlined in the Costing

Transformation Programme (CTP)

improve the quality of costing and consistency of the cost data

support the development of the 2019/20 national tariff

provide better information for decision-making and the national PLICS portal

align the collection to the healthcare costing standards for England: Acute,

development version 2.

1 NHS Digital (formerly the Health and Social Care Information Centre): https://www.digital.nhs.uk/

https://www.digital.nhs.uk/


The main changes for 2016/17 are:

the transition from costs pools to resources and activities for the reporting of unit

costs

revision of the underlying costing standards that apply to the collection

move to XML collection files instead of XLS to support an automated and efficient

collection of more detailed data

inclusion of accident and emergency (A&E) and outpatient (OP) attendances in the

scope of the collection

materiality and quality score no longer collected

introduction of the costing assessment tool (CAT) which providers should submit to

NHS Improvement (see Section 13).

Additional changes in March 2017 update

We have added further instructions for the collection. The main additions are:

finalised collection data fields and extracts (see section 10)

data validations (see section 10.4)

CAT submission date added (see section 13)

further guidance on education and training (E&T) costs (see section 6.8).

1.3. Background

The NHS in England currently (2016/17) makes two national cost collections: combined

collection (includes reference costs and E&T) and PLICS. With the two collections it is

difficult to determine if costs vary because of differences in clinical or operational practices,

or in the costing method applied by organisations.

One common issue for providers in the 2015/16 reference costs collection was their costing

approaches not aligning with our approved costing guidance.2 Inaccurate costing

approaches can distort the national average cost – for example, if time in theatre is used to

allocate prostheses costs across all surgical patients, the average costs for procedures

involving prostheses will be reduced.

In response to these issues, we are developing the collection process with a view to

combining the two cost collections into a single collection by 2018/19. This will improve the

consistency of the costing methods applied across the national collections and once

2 https://improvement.nhs.uk/uploads/documents/NHSI_RCA_Sector_Report_-_final.pdf

https://improvement.nhs.uk/uploads/documents/NHSI_RCA_Sector_Report_-_final.pdf


established will reduce the burden on providers. The CTP focuses on patient-level costing to

deliver a step change in the quality of cost information: the single national cost collection is

vital to achieving this.

The single national cost collection will closely align with providers’ local costing methods,

minimising the work they need to do to complete the national cost collection, and will give

the service a consistent costing method. We expect that cost collection coupled with the

implementation of the healthcare costing standards for England will:

improve the quality and consistency of cost information available to the service

ensure organisations can understand their costs

allow organisations to benchmark their costs against those of their peers.

The move to a two-year tariff for 2017/18 and 2018/19 marks the beginning of the transition

of the cost base from reference costs to PLICS as both datasets will be used to inform the

2019/20 national tariff.

Benefits of the single cost collection

The single cost collection will benefit the service as follows:

easier collection, as the required outputs are generated directly by the costing

systems employed

easier analysis of and greater insight into the cost data as there will be a better

understanding of which resources deliver which activities. The output format

accommodates different care settings (mental health, acute, ambulance and

community services) with a set of activities/resources for each of these settings

reduced burden as one not two collections.

2. Scope

2.1. In scope

The 2016/17 collection is designed to capture the unit costs from NHS providers (CTP early

implementers), split by resources and activities for acute services for NHS patients in

England.


This collection includes contracted-out (to other NHS providers or the independent sector),

any qualified provider3 and overseas (reciprocal) activity.4 Activity datasets that should be

reported at patient level for this collection are:

admitted patient care (APC) finished consultant episodes (FCEs), including regular

day and night attenders, and patients not discharged before or on 31 March 2017

non-admitted patient care (NAPC) attendances, also known as outpatients (OP),

including ward attenders

A&E attendances.

Collection year

The collection year begins on 1 April 2016 and ends on 31 March 2017. All episodes and

attendances completed within the collection year or episodes still open at the end of it are in

scope of this collection. A&E attendances that started on 31 March 2016 and finished on 1

April 2016 are also in scope.

Only resources and activities undertaken in the collection year should be reported. If part of

the episode falls outside the collection year, this should not be costed, as shown in Figure 1

below. See Standard CM2: Incomplete patient events for more guidance on the costing of

incomplete episodes.

Figure 1: In-scope episodes

3 https://www.england.nhs.uk/wp-content/uploads/2012/09/procure-brief-2.pdf (page 3) 4 http://www.nhs.uk/NHSEngland/Healthcareabroa/countryguide/NonEEAcountries/Pages/Non-EEAcountries.aspx

https://www.england.nhs.uk/wp-content/uploads/2012/09/procure-brief-2.pdf

http://www.nhs.uk/NHSEngland/Healthcareabroa/countryguide/NonEEAcountries/Pages/Non-EEAcountries.aspx


2.2. Out-of-scope services and reconciliation items

Services outside the scope of this collection should not be reported in the patient-level cost

collection extracts, but should be costed and reported in the reconciliation tables to ensure

the correct quantum is generated. Table 1 below describes the cost groups under which

services should be reported.

All the services listed in Table 1 must be costed, but only those services which fall under the

own-patient care cost group should be reported in the patient-level extractions. All other cost

groups form part of the reconciliation tables outlined in Section 9.

Table 1: Reporting of services by cost group in the reconciliation tables (see Section

9 for information on reconciliation tables)

Cost groups Service description Reconciliation tables or

patient-level extracts

Own-patient care All acute NHS services in England, not listed in any other cost group below including:

costs related to the provider’s own-patient activity

overseas (reciprocal) activity

activity sub-contracted to other providers

(independent or NHS)

Patient-level extracts

Own-patient care (out of scope)

Overseas patients (non-reciprocal)

Other countries of Great Britain (Wales, Scotland

and Northern Ireland)

Private patients

Ambulance services

Mental health services

Community services (including community

midwifery)

See reference costs collection guidance for

definitions of the following services:

armed forces

critical care transportation

specialist palliative care

renal dialysis

rehabilitation

cancer multidisciplinary team meetings

cystic fibrosis drugs

discrete external aids and appliances

health promotion programmes

home delivery of drugs and supplies

hospital travel costs scheme

intermediate care

learning disability services (TFC 700)

Reconciliation tables


named providers – specified services

NHS continuing healthcare, NHS-funded nursing

care and excluded intermediate care for

individuals aged 18 or over

NHS continuing healthcare, NHS-funded nursing

care for children

patient transport services (PTS)

pooled or unified budgets

primary medical services

prison health services

screening programmes

specified hosted services

Other activities Activities contracted in from other providers, eg

providing pathology services for another provider

Commercial services, eg car parking, hospital shop or

hospital restaurant

Direct access services


Reconciling items (no corresponding activity)

Provider-to-provider service-level agreements with

no activity data

Other services, eg youth worker employed for

council-funded work


Education and training (E&T)

Salaried or non-salaried training programmes that

lead to a professional registration (see reference

costs collection guidance)


Research Research and development (R&D) that is centrally

funded and comprising several funding streams

R&D that is privately funded and comprising several

funding streams

Research that is funded by an external third party,

such as Cancer UK

Research as part of a funded trial, such as by a

pharmaceutical company

Internal NHS research


Some services within own-patient care (out of scope), other activities, reconciling items,

research and E&T cost groups will be brought into the scope of the collection in future years

and collected using the patient-level extracts.

If you are unsure if a service is in or out of scope for collection, please email

[email protected] for clarification.

http://connect2.monitor-nhsft.gov.uk/sites/PricingDelivery/Costing/MonitorDocumentLibrary/Approved%20Costing%20Guidance/1617/DRAFT%20ACG%20doc%20Jan%2017/Ready%20for%20review/[email protected]


2.3. Role of NHS Digital and Hospital Episode Statistics

NHS Digital

NHS Digital provides a range of services used by healthcare professionals, research bodies,

public sector organisations and commercial entities across England. NHS Digital is

experienced in specifying, acquiring and processing national data collections.

For the CTP, 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. The collection system will:

enable providers to submit patient-level costing information to NHS Digital in a secure

manner

link patient-level costing information to the HES dataset

conduct data validation and quality checks

supply anonymised patient-level costing information to NHS Improvement for onward

data processing and analysis.

Health Episode Statistics (HES)

HES holds details of all NHS admitted patient care (APC), outpatient appointments and A&E

attendances in England. It includes clinical information about diagnoses and operations, and

patient details, such as age group, waiting times and date of attendance.5

HES provides one half of the cost collection data NHS Improvement will receive from NHS

Digital. The other half of the collection data is defined in the submission extract specification

(see Section 10). This describes the fields we ask providers to submit to NHS Digital in the

summer 2017 collection.

To link the two datasets, NHS Improvement has included a CDS unique identifier6 in the

collection field list which NHS Digital will use as the primary matching key.

By linking to HES NHS Improvement can collect a shortened extract from providers. This

helps ensure only one version of activity data is used by NHS Improvement, reducing

inconsistencies in data analysis between the cost data and HES analysis. The shortened

collection also reduces the file size for providers, and in future will reduce the burden of the

collection. For example, there may be no requirement to run the activity data through the

reference costs grouper if all the relevant fields are available from the HES dataset, saving

providers’ time spent on data preparation.

5 http://content.digital.nhs.uk/hesdata

6 http://www.datadictionary.nhs.uk/data_dictionary/data_field_notes/c/cds/cds_unique_identifier_de.asp

http://content.digital.nhs.uk/hesdata

http://www.datadictionary.nhs.uk/data_dictionary/data_field_notes/c/cds/cds_unique_identifier_de.asp


3. Collection timetable Tables 2 and 3 below outline the timetables for reference costs and the PLICS collections

for 2017. The reference costs collection window has been extended for early implementers

only, to provide sufficient time for them to implement the Healthcare costing standards for

England: Acute development version 2.

Table 2: Timetable for PLICS (CTP) cost collection

Date Description

Jan 2017 Costing standards, collection guidance and minimum software requirements published

June to July 2017 PLICS test data submission window*

July 2017 PLICS submission window

Early Aug 2017 Contingency for further PLICS submissions

Nov 2017 PLICS resubmissions window**

* We will contact providers in April/May to confirm test dates.

** We will report any issues identified from our early review of the collection data to providers to give them the

opportunity to resubmit.

The exact submission dates for providers will be confirmed through the monthly

implementation regional support meetings.

Table 3: Reference costs collection

Date Description

Jan 2017 Collection guidance for reference costs* published

19 June to 4 Aug 2017

Reference costs* submission window – for providers not submitting CTP PLICS

19 June to 15 Sept 2017

Reference costs* submission window – for providers submitting CTP PLICS

18 Sept to 16 Oct 2017

Reference costs* potential resubmissions window**

* Reference costs (RC) includes RC collection (RC net of E&T income) and the integrated cost collection (RC

net of E&T costs).

** We will report any issues identified from our early review of the collection data to providers to give them the

opportunity to resubmit.


4. Applying the healthcare

costing standards for England The cost collection should be completed in line with the guidance set out in the Healthcare

costing standards for England: Acute development version 2, which specifies how you

should map costs to resources and activities, and the allocation methods that should be

used.

Where the costing standards do not provide guidance on how to treat specific costs for

collection, see Section 6 first, and if this does not help then email the NHS Improvement

costing team at [email protected] for clarification.

5. Applying the reference

costs grouper

Providers will need to run the datasets outlined in Section 2.1 above through the 2016/17

reference costs grouper7 to generate the episode/attendance health resource group (HRG)8

(HRG) and spell HRG.

Where the data is invalid for grouping, eg incomplete episodes, report UZ01Z HRG for these

activities.

7 http://content.digital.nhs.uk/casemix/costing

8 http://content.digital.nhs.uk/hrg?tabid=2


http://content.digital.nhs.uk/casemix/costing

http://content.digital.nhs.uk/hrg?tabid=2


6. Treatment of specific costs

and services/activities:

additional guidance

This section gives guidance additional to the healthcare costing standards for England for

the consistent allocation of specific costs.

6.1. Well babies

All activities and resources associated with the treatment of well babies (TFC 424 and HRG

PB03Z (healthy baby)) should be reported against the well baby episode of care and not the

mother’s. The mother’s local patient ID should be reported against the birth episode.

6.2. Unbundled services

This section covers unbundled services for critical care, diagnostic imaging, high cost drugs

and devices and radiotherapy. These services are unbundled for reference costs (see the

Reference costs guidance) and reported separately from the core episode. However, for the

PLICS cost collection you should not unbundle these costs and activities. Instead, you

should match them to the core episode/attendance using the appropriate resource and

activities, as outlined in the costing standards sections in Spreadsheets CC.2 and CC.3 in

the costing standards technical guidance.

As outlined in Section 2.2 above, rehabilitation, specialist palliative care and renal dialysis

are outside the scope of the 2016/17 PLICS collection. The fully absorbed costs, and any

episodes and attendances which relate to these services only, should be excluded and

reported under own-patient care (out of scope) in the reconciliation. See the Reference

costs guidance for more information on unbundled services.

Critical care

Providers can report critical care costs using either (see Figure 2):

1. distinct critical care episodes in APC (created in their patient administration system

only)

2. core treatment and procedure episodes.

https://improvement.nhs.uk/resources/approved-costing-guidance/




Figure 2: Critical care reporting options. Patient example: total length of stay 10 days,

admitted (core episode) for abdominal surgery (eight days) and two days in critical

care

8 days 2 days

Option 1 Core episode

Critical care episode

Option 2 Core episode

Critical care costs should be reported against the relevant APC episode using the critical

care collection activity to identify, for example, the critical care ward and medical staffing

costs. Any associated diagnostics or therapy costs should be reported in accordance with


Critical care transport

Transportation costs for paediatric and neonatal critical care transfers are out of scope of the

collection. We will consider whether these costs should be included in the 2017/18

collection, but for 2016/17 you should report critical care transportation costs as own-patient

care (out of scope).

Critical outreach

Costs associated with the running of outreach support teams – activities which occur outside

the critical care unit – must be allocated across APC attendances using length of stay as a

weighting. Costs should be reported using the ward care collection activity.

Chemotherapy

Chemotherapy delivery and drug costs should be allocated to the core APC episode or

attendance. Most delivery costs will be reported against the ward or outpatient collection

activity, with chemotherapy drugs reported against dispensing chemotherapy drugs activity.

Where chemotherapy and radiotherapy are given in the same APC episode or attendance,

radiotherapy costs will be identified through the radiotherapy collection activity; all other

supportive care costs for the attendance are assumed to relate to chemotherapy. This area

is work in progress for PLICS and we intend to look at how to capture the associated

supportive costs in the relevant chemotherapy or radiotherapy collection activity.


Drugs

Two collection activities have been created in the collection resources and activities matrix

for high cost drugs: dispensing of high cost drugs on the list and dispensing of high cost

drugs off the list. Drugs that have an OPCS code and therefore will generate an unbundled

HRG have been mapped to high cost drugs on the list in the costing standards. Drugs that

either are not funded through the national tariff and do not have an OPCS code, or have

been flagged in the Reference costs guidance as future high cost drugs should be reported

as high cost drugs off the list.

Both types of drugs should be reported against the relevant episode or attendance in which

the drugs were consumed in the submission extract.

Devices

In April 2016 NHS England introduced a nationwide system for purchasing expensive

medical devices and implants used in specialised services from the NHS supply chain.9 This

new approach will be phased in across providers, with these devices and implants

eventually incurring zero cost for providers.

For the PLICS collection, where a patient has a device listed in Appendix 5 of the costing

standards technical guidance, report your organisation’s incurred cost or zero cost against

the devices, implants and prostheses – on-list resource.

Report any high cost devices not on the list and not funded through the national tariff using

the resource devices, implants and prostheses – off-list.

6.3. Multidisciplinary team (MDT) meetings

Cancer MDTs are a standalone dataset with no patient-level data to match activities to. As a

result they are out of scope for the patient-level extract. Report cancer MDTs (both OP and

APC) in the reconciliation as own-patient care out of scope.

Report costs of all other types of MDT relating to APC and OP against the relevant episodes

and attendances. If the costs for these MDTs are known, then report the relevant collection

resources under the other MDT collection activity.

6.4. Staff on long-term leave

Where patient-facing resources relate to staff on long-term leave (four or more weeks of

consecutive leave, eg sick or maternity leave) there will be no activities to match resources

to. Treat these costs as a support cost to the service or department, and allocate across all

9 https://www.england.nhs.uk/commissioning/spec-services/key-docs/medical-devices/


https://www.england.nhs.uk/commissioning/spec-services/key-docs/medical-devices/


patients treated in the service or department. The materiality principle should be applied

before adjusting the allocation method for staff on leave.

Where leave is not classified as long term, allocate these costs using the method outlined in


6.5. Sexual health, HIV services and other confidential

services

Where information governance rules mean a patient cannot be identified in the PLICS

activity data, report an anonymised episode or attendance for activity in the submission

extracts.

6.6. Excess bed days

Excess bed days must not be reported separately from the APC episode. The costs for

excess bed days must be reported under the relevant resources and activities outlined in

Section 11.

6.7. Reporting requirements for mergers and acquisitions

If providers merge or a provider is acquired by another, then the merger reporting

requirements set out in the Reference costs guidance must be followed for the PLICS cost

collection.

6.8. Education and training costs

For early PLICS implementers the reference costs collection window is scheduled after the

PLICS collection window. It is possible providers will not know their E&T costs in time for the

PLICS collection. If this is the case, you should estimate the E&T cost quantum to exclude

from the PLICS collection. You could estimate this by, for example, using last year’s

apportionment tables with this year’s final accounts, or using last year’s costs and applying

an inflation factor. Providers should not use E&T income as an estimate of costs.

https://improvement.nhs.uk/uploads/documents/Reference_costs_collection_guidance_201617.pdf


7. How we will use the

collection data We intend to use the acute 2016/17 PLICS cost collection data primarily to establish

comparative data for the early implementers to allow them to compare their costs and

identify opportunities to improve service models and the quality of their costing.

We are developing a PLICS portal to give user-friendly access to the cost data. Data can be

analysed using customised and standard reports. It will be available to early implementers

by December 2017.

We may use the data in connection with any of our pricing or other functions:10

informing the 2019/20 national tariff

informing and modelling new methods of pricing NHS services

informing new approaches and other changes to currency design

informing the content of the summer 2018 cost collection

testing and strengthening the validation and extraction process for the collection

providing data for the impact assessment required as part of the decision whether or

not to make the cost collection and costing standards mandatory

informing the relationship between provider and patient characteristics and cost

developing analytical tools and reports to help providers improve their data quality,

identify operational and clinical efficiencies, and review and challenge their patient-

level cost data. This may involve giving providers access to suitably anonymised or

aggregated PLICS data.

As well as sharing the data within NHS Improvement,11 we may share suitably anonymised

or aggregated PLICS data with our partner organisations (such as NHS England and NHS

Digital), other arm’s length bodies of the Department of Health, private bodies and higher

education institutions (HEIs) to help them deliver any of the programmes of work listed

10

See Section 70 of the Health and Social Care Act 2012. 11 Including sharing in connection with the functions of the NHS Trust Development Authority, as well as the functions

of Monitor.


above or for any other purpose relating to our functions. We will have appropriate data

sharing arrangements for disclosing data to third parties.

8. Board approval and sign-off The PLICS submission is a national return that providers should subject to the same scrutiny

as their final audited accounts. An executive sponsor for PLICS should sign off the cost

collection and ensure the following steps have been taken:

the cost return has been prepared in accordance with NHS Improvement’s approved

costing guidance, which includes the costing standards and the cost collection

guidance

reconciliation sheets have been checked to ensure the correct activity and cost

quantum have been used

data validations have been reviewed and any material errors corrected.

a self-assessment checklist has been completed and reviewed (see Section 13).

9. Reconciliation tables Reconciliation is an important part of the submission files (see Section 10). The

reconciliation tables below help to establish the PLICS quantum from your final audited

accounts, and outline material differences between your HES and PLICS totals for

attendances and episodes. The four reconciliation tables are:

final audited accounts

cost groups

out-of-scope services and costs

activity reconciliation.

These tables, with the exception of the activity reconciliation, are a software requirement

and must be generated by the costing software as part of the costing process; please refer

to the file specifications for the reconciliation tables. This reduces the burden on costing

practitioners by removing the need for them to prepare cost data for a national cost

collection that is inconsistent with the output tables produced as part of the local costing

process.

https://improvement.nhs.uk/resources/201617-plics-cost-collection-guidance-file-specifications


9.1. Final audited accounts

The final audited accounts table has been updated to mirror the reference costs, ensuring

both collections create the correct provider total quantum.

This table should reconcile to your audited accounts (see the Reference costs guidance).

Report all your organisation’s costs as well as other operating income and gains in the final

audited accounts table. Contact the NHS Improvement costing team at

[email protected] to discuss the treatment of rare items, eg merger and

acquisition costs, or if you are unsure how to report some costs.

9.2. Cost group reconciliation (Main cost groups)

Once the provider total quantum has been defined, costs and other operating income should

be categorised into six cost groups:

E&T

research

own-patient care

own-patient care (out of scope)

other activities

reconciling items (no corresponding activity).

Own-patient care (out of scope) reflects the patient care services which have been excluded

from the scope of the collection, eg community services (see Section 2.2 above). Separating

them allows you to define the quantum for the collection as the ‘own-patient care’ group. All

other groups of cost and activity data should not be reported in the patient-level submission

files.

Report total costs and other operating income by cost groups in line with the costing

standards guidance for the cost group reconciliation table. Table 5 below shows an example

cost group table.

Data validations will check the ‘provider total quantum’ from the final audited accounts

reconciliation table against the total costs in the cost group reconciliation table, to ensure the

correct provider quantum of costs has been reported. Other operating income will not be

included in the collection quantum as this is a cost-only collection.




9.3. Out-of-scope services and costs (Sub cost groups)

This table provides a breakdown of the reconciling items, other activities and own-patient

care services that are outside the scope of the collection. This gives transparency to the

services provided, and validates whether all services are costed and the correct services are

removed from the quantum. Table 1 above describes the cost groups for NHS acute

services.

The costs in this table should be divided between total cost and other operating income in

line with the costing standards.

If you are unsure where to report some of your services, contact the NHS Improvement

costing team at [email protected].

9.4. Activity reconciliation

HES extracts are taken from the secondary uses service (SUS) data warehouse on a

monthly basis. All episodes and attendances reported for PLICS should be reconciled to the

final SUS data reported for the collection year. We recommend you agree your activity

numbers with your informatics department to ensure you have the correct data for reporting.

The activity reconciliation will form part of the early implementer syllabus, which is a set of

tasks which helps providers with implementation of the standards and their cost collection.

Non-SUS activity

If attendances or episodes are not included in your organisation’s SUS submissions but are

reported in A&E, APC or OP for reference costs (see the Reference costs guidance), then

include this activity in the PLICS submission and highlight this in the activity reconciliation.

If you have any questions regarding non-HES activity, email [email protected].

10. Collection extract files

overview

The costing standards technical document published in January 2017 listed all possible

fields for collection in 2017. We have since completed the testing of the matching rules

between HES and PLICS, and the collection specification for 2017 is now confirmed.

This section details the requirements for the patient-level extracts to be submitted to NHS

Digital via a data validation tool. We will issue providers with a data validation tool in

mailto:[email protected]




May/June 2017 which will validate costing outputs and produce required XML files to be

transferred to NHS Digital.

The tool will process CSV or XML files, perform data validations, generate and compress

XML files ready for submission to NHS Digital. It benefits the collection in the following ways:

ensures that data is in the correct format for submission, reducing the likelihood of

resubmission

allows providers to validate data and correct any issues if needed before submitting

data

reduces the burden on software suppliers to create and validate XML files

removes the need for manual compression of files.

We recommend providers check the quality of their output files in the data validation tool

before transferring these to NHS Digital, to minimise potential submission failures and

resubmissions.

10.1. File specification and data fields

This section details the file format and data fields for the submission to NHS Digital. The

output file must conform to the standard specified in the collection specification files.

Files sent to NHS Digital must be in XML format. To reduce the burden on providers and

suppliers we will provide a data validation tool that converts CSV files into XML and runs the

collection data validations. Alternatively, if providers can produce XML files, the tool can be

used to run the collection data validations only.

See the collection specification files for the CSV and XML data fields and formats. There are

example CSV and XML extract files to support file creation.

In previous PLICS collections there has been one row of cost data per episode. With the

introduction of resources and activities, the collection XML becomes multi-tiered, with the

episode/attendance at level 1 and collection activities (level 2) and collection resources

(level 3). This hierarchy is demonstrated in the XML extract examples.

However, the hierarchy cannot be built in the CSV files as they are flat files – the patient

details repeat for each combination of resources and activities.

If you have any questions about the file specification please contact the NHS Improvement

costing team at [email protected].




10.2. File batching process

The file batching process has been designed to future proof the collection to support

monthly, quarterly and annual reporting, and to ensure the file transfer process can upload

the large data files produced by the new costing method.

The submission files need to be batched in two steps:

1. group the data into three datasets: APC, OP and A&E

2. split each dataset into 12 months using the activity end date and time. Where the

episode is incomplete and the episode end date and time is blank, or later than 31

March, then please include these records in the M12 file for the APC dataset.

The only exception is for the reconciliation tables which are grouped into one table. See the

reconciliation extract specification and file example.

10.3. Extract file name convention

Table 4 outlines the file naming convention and gives examples. If file names do not follow

this convention their submission will fail.

Table 4: File name convention

Property Description FeedType The dataset the extract covers (APC = admitted patient care OP =

outpatients AE = accident and emergency, REC = Reconciliation)

FYccyy-yy The financial year the extract covers, eg for 2016/17 the value is

FY2016-17

Month The month within the financial year the extract covers. For the

2016/17 collection the period equals month*:

M## = the month in the financial year

M01 = April

M02 = May

M03 = June

M04 = July

M05 = August

M06 = September

M07 = October

M08 = November

M09 = December

M10 = January

M11 = February

M12 = March

This is not required for the reconciliation file

OrgSubmittingID

The organisation identifier (code of submitting organisation) is the

identifier of the organisation acting as the physical sender of a



dataset submission

The organisation code provided must be in the three-character

format (XXX)

CreateDateTime The date and time the extract was created

Format to be used: CCYYMMDDThhmm

* Additional periods which may be collected in future are Q## = the financial quarter the extract covers - (eg

Q01 will include April, May & June) and X = the whole financial year.

Examples of correctly named files:

FeedType_FYccyy-yy_Month_OrgSubmittingID_CreateDateTime

APC_FY2016-17_M01_XXX_20170701T1730.xml or APC_FY2016-

17_M01_XXX_20170701T1730.csv

10.4. Data validation

The data validations performed on the collection extracts by the data validation tool are

contained in the spreadsheet Data validations. Data validations have been kept to a

minimum this year to reduce the burden on providers. Data validations are split into two

groups:

1. Mandatory checks. These are validations which result in a submission failure and

must be addressed, which cover the validity of the data submitted and file structure.

Four categories of checks will be performed:

Is the field length correct?

Is the data format valid, eg is the date and time format correct?

Where relevant, is the value presented valid, eg correct resource ID?

Are the extract file and the manifest file in the correct structure?

2. Non-mandatory checks highlight fields which need to be reviewed as part of the

submission sign off process, but may not require action. Some of the checks are for

excessive costs and fields required for HES matching and date ranges.



11. Collection resources and

activities

This section describes the resources and activities you should use to report costs for this

collection.

Spreadsheets CC.2 and CC.3 in the costing standards technical guidance contain a list of

the resources and activities respectively for collection. A resource activity matrix has been

included in Spreadsheet CC.4 and in Table 5 below to show the expected combinations for

collection. Other combinations will be accepted for this collection.

Spreadsheet CP2.1 in the costing standards technical guidance maps a standardised cost

ledger to the cost collection resources. This should assist you with your cost classifications

for the PLICS collection. If you have combinations that do not appear in Spreadsheet CC.4

or costs in your ledger that are not represented in Spreadsheet CP2.1, please email the

NHS Improvement costing team at [email protected] to discuss.

Spreadsheet CP2.3 shows how to group the local activities in the costing standards to

produce the collection activities.

Appendices 5 to 7 in the costing standards technical guidance provide detailed examples for

a selection of resources and activities, illustrating what the collection resources and activities

consist of.


25 | Acute > 2016/17 PLICS cost collection guidance

Table 5: Resource and activity matrix

______________________________________________________________________________________________________________

Activity group

(for reporting purposes)

Collection Activity

(this is the cost collection level)

Bloo

d an

d bl

ood

prod

ucts

MSS

E

Cons

ulta

nts

Devi

ces,

impl

ants

and

pros

thes

es -

off l

ist

Devi

ces,

impl

ants

and

pros

thes

es -

on li

st

Drug

s

Emer

genc

y de

pt

Radi

othe

rapy

dep

t

Oth

er c

linic

al st

aff

Oth

er d

octo

rs

Out

patie

nt d

ept

Path

olog

y de

pt

Phar

mac

y de

pt

Radi

olog

y de

pt

Spec

ialis

t nur

se

Thea

tre

dept

Ther

apie

s

War

d co

sts

Supp

ort d

ept

Oth

er c

osts

Oth

er d

iagn

ostic

s dep

t

Spec

ialis

t pro

cedu

re su

ite

dept

CNST

Blood Dispensing blood products

Critical care Critical care

Diagnostic imaging CT

Diagnostic imaging Dexa scan

Diagnostic imaging Fluoroscopy

Diagnostic imaging MRI

Diagnostic imaging Nuclear medicine

Diagnostic imaging Ultrasound - obstetric

Diagnostic imaging Other diagnostic imaging

Diagnostic imaging Plain film

Diagnostic imaging Ultrasound (non obstetric)

Emergency care Emergency care

MDTs Other multi-disciplinary team meetings

Other diagnostic testing Other diagnostic testing

Other diagnostic testing Screening

Other diagnostic testing Respiratory Investigations

Other diagnostic testing Other cardiac non invasive investigations

Other diagnostic testing Neurophysiology Investigations

Other diagnostic testing Echocardiogram (ECHO)

Other diagnostic testing Audiology assessments

Other diagnostic testing Urodynamic Investigations

Outpatient care Outpatient care

Pathology All other tests

Pathology Biochemistry

Pathology Haematology

Pathology Genetics

Pathology Immunology

Pathology Cellular sciences

Pathology Microbiology

Pharmacy Dispensing chemotherapy drugs

Pharmacy Dispensing high cost drugs (off the list)

Pharmacy Dispensing high cost drugs (on the list)

Pharmacy Dispensing other drugs (directly to patients)

Pharmacy Pharmacy (other activity)

Radiotherapy Radiotherapy

Specialist procedure suites Endoscopy

Specialist procedure suites Interventional radiology

Specialist procedure suites Other specialist procedure suites

Specialist procedure suites Cardiac catheterisation laboratory

Theatre care Anaesthesia

Theatre care Surgical care

Therapies Dietetics

Therapies Occupational therapy

Therapies Other therapies

Therapies Physiotherapy

Therapies Podiatry

Therapies Speech and language therapy

Ward care Ward care

Support services Other support services

Collection Resource

26 | Acute > 2016/17 PLICS cost collection guidance

12. Data submission

We are working with NHS Digital to finalise the submission process. Guidance will be sent

to providers and suppliers in April/May.

This will include:

a data validation tool

file transfer set up and process

submission process – an outline from start to finish

board sign-off process and self-assessment checklist.

The self-assessment checklist is to be completed and submitted by email direct to NHS

Improvement. The self-assessment checklist (XLS files) is to be signed-off by an executive

sponsor within the provider organisation.

13. Costing assessment tool The costing assessment tool (CAT) is a spreadsheet-based questionnaire to be used in

association with the healthcare costing standards for England, acute version 2.

You should return the completed tool to [email protected] by 31 August 2017.

The tool provides an objective assessment of the:

quality of costing at each provider

degree to which the costing standards have been implemented.

By breaking the costing process down into different stages (see below), the CAT tool will

enable you to identify where in the costing process improvements can be made. It also

provides evidence to help you engage with provider senior managers and clinicians to

secure resources and decisions to improve the collection of data where necessary.

At a national level the CAT will provide data to assess the current status of costing in the

service. This will inform decisions on national initiatives to improve the quality of costing. It

will also inform the use of data for benchmarking, identify possible productivity opportunities

and help with tariff development.

The CAT has six sections:



1. detailed and accurate data

2. clearly identifiable costs

3. appropriate cost allocation methods

4. matching

5. reconciliation

6. reporting and engagement.

The sections cover the different phases of the costing process in the order in which they

would normally run.

The first three sections are named according to the three fundamental pillars of the costing

process as set out in the costing standards.

Each section consists of a series of questions to which the possible responses are: Yes (Y),

No (N) or Not applicable (N/A).

Where providers have partially implemented a specific requirement there is the option to

qualify the response of Yes with a percentage coverage. Coverage will be based on cost

value or activity volume and will be specific to each question.

Each section has a pre-defined weighting which dictates its relative importance in the overall

score. This is independent of the number of questions in each section.

For questions on cost allocation methods the CAT requires you to enter the activity or

resource cost values. There is a requirement in the minimum software requirements12 for

software suppliers to produce a report to populate the CAT.

These are used to weight the relative importance of each question so that compliance with

the adoption of a particular cost allocation method will score more highly the higher the

value of the associated resource.

As the CAT aligns with the costing standards and assesses every phase of the costing

process it provides a comprehensive view of the quality of costing in an organisation.

12 https://improvement.nhs.uk/resources/minimum-software-requirements/

https://improvement.nhs.uk/resources/minimum-software-requirements/

https://improvement.nhs.uk/resources/minimum-software-requirements/

Contact us:

NHS Improvement

Wellington House

133-155 Waterloo Road

London

SE1 8UG

0300 123 2257

[email protected]

improvement.nhs.uk

Follow us on Twitter @NHSImprovement

This publication can be made available in a number of other formats on

request.

© NHS Improvement 2017 Publication code: CG 25/17

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