News / Cost report shows PLICS potential

NHS providers have made progress with their patient-level information and costing systems (PLICS) data over the past three years, but data quality issues still remain, NHS Improvement has said.

In a publication summarising analysis of patient cost data submitted as part of a voluntary collection covering 2014/15, NHS Improvement said the findings ‘continue to demonstrate the need for improved and more prescriptive standards and a wider, mandatory PLICS collection from all providers’.

A new costing methodology is being introduced as part of the organisation’s Costing Transformation Programme.

Submitted data was ‘relatively clean’, but the report drew attention to issues to be considered for the next collection – the selection of dominant procedures in an episode, the inclusion of implausible figures in some data feeds and the submission of invalid healthcare resource groups.

While costing data submitted using the new methodology in the future will realise more benefits, the report said the current data showed the power of being able to analyse cost data vertically (down to patient level) and horizontally (by components of costs currently collected in cost pool groups).

The 2014/15 data showed that the three biggest contributors to total acute care costs were wards (24%), overheads (19%) and medical staffing (16%). Operating theatres (not including medical staffing) contributed a further 9% of costs.

The analysis also shows that other cost types can be major contributors in specific areas of care. For example, in episodes involving the use of critical care services, the critical care component accounted for 29% of all costs.

The report said that medical staff and ward costs had increased as a proportion of all costs over the past three years, possibly as a result of improved costing, while overheads had reduced. It also found that cost breakdown changes across provider types, with overheads and critical care costs accounting for a greater proportion of all costs in specialist providers, while ward costs proportionally were smaller.

Showing the potential for further analysis, the report also highlighted wide variation in theatre times even for the same HRG, point of delivery type and dominant procedure.