Payment - HRG4+ 2017/18 Local Payment Grouper
Download the HRG4+ 2017/18 Local Payment Grouper application and associated documentation. This product contains the update to the underlying classification OPCS-4.8, which came into effect on 1 April 2017.
The Local Payment Grouper has been developed to be used in line with the National Reimbursement System, as produced by NHS England and NHS Improvement.
The Local Payment Grouper should be used to:
- group data and derive HRGs
- support data quality
- conduct what-if modelling
- assess local reimbursement that will be received under the National Tariff for the 2017/18 financial year
It should be used in conjunction with the Grouper user manual, which explains how data should be sorted and presented for processing by the Grouper.
Before using the Grouper, please read the summary of changes to understand the changes. The introduction of the HRG4+ design for reimbursement purposes is a significant design update.
The Local Payment Grouper has also been updated to reflect advances in usability and performance, and users are advised that the new product will look different to the previous versions. As with previous releases, users must be aware that the Grouper does not apply certain tariff business rules; for example, Prescribed Specialised Service flagging, which are now used to apply reimbursement top-ups where applicable.
Activities relating to Treatment Function Code or other pre-processing exclusions should also be removed from the input data before running through the local Grouper. As HRG exclusions are at spell level, and the HRG4+ Grouper produces both episode and spell-level HRGs during the same run, HRG exclusions should be made at spell level following grouping. There is no requirement to group data twice. Organisations choosing not to remove exclusion data may generate HRGs that are excluded from national tariff under national funding policy.
In response to problems installing and uninstalling the new product, we've published a product install and uninstall guide [1003.71KB] to assist users, which includes the minimum system requirements and troubleshooting guidance.
Over the coming months, we're looking to enhance the functionality of the Grouper products. To get involved in the future product development as a beta tester, or if you have ideas or feedback on the current product, please contact firstname.lastname@example.org.
Summary of changes [836.15KB] - please read this before using the Grouper.
Casemix companion [1.3MB] - a starting point and general reference guide for anyone interested in learning about the casemix classification system used by the NHS in England. It provides an introduction to HRGs, Groupers, HRG4+ design concepts and grouping logic, and it contains links to additional resources.
OPCS update [793.96KB] - outlines the changes made due to the underlying update of the OPCS primary classification to OPCS-4.8, which is mandated for use from 1 April 2017.
Chapter summaries [1.86MB] - an overview of the scope, composition and grouping logic of individual subchapters, including the update to the HRG design.
Code to group and user manual [8.48MB] - this workbook provides details of constituent elements that contribute to HRG grouping. It contains reference data, such as the ICD-10 and OPCS-4 codes used in the design, procedure and diagnosis hierarchies relevant to a specific design, and the Complication and Comorbidities lists for HRG subchapters. It also includes information on Programme Budgeting Category (PBC) mapping and a comprehensive list of HRG codes and labels, including other fields used by the Grouper. The user manual explains how to use the workbook.
Test data and expected results [187.05KB] - download sample data to test the Grouper installation (running the sample data should result in 90% grouped, 10% ungrouped). The file format of the sample data is representative of that in the sample RDFs, provided within the Grouper application. These files can easily be used as example patient data, or as a template to understand the required input to the Grouper to enable successful grouping.
Guide to best practice flags [2.21MB] - this workbook contains details on the criteria and logistics of how the Grouper allocates specific identification flags relating to best practice. Best practice flags result in an adjustment to the base HRG tariffs, and the workbook also contains details of these specific tariff adjustments.
Specialised service identification code sets [951.71KB] - this contains details about the flags and trigger codes relating to SSCs, which are still output by this Grouper product for benchmarking purposes, but which have now been superseded by Prescribed Specialised Service identification flags as a basis for top-up reimbursement. SSCs will be removed in subsequent releases.