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Publication, Part of

Acute Patient Level Activity and Costing, 2018-19

Experimental statistics, Other reports and statistics

Current Chapter

Relationship to NHS England and NHS Improvement’s National Cost Collection (NCC) outputs


Relationship to NHS England and NHS Improvement’s National Cost Collection (NCC) outputs

NHS England and NHS Improvement’s Costing Transformation Programme includes a phased replacement of annual aggregate costing data submissions with Patient Level Information and Costing System (PLICS) record level collections.

During the transition to patient level collections, some data continues to be collected by NHS England and NHS Improvement at aggregate level. For example, providers of acute care in other sectors such as mental health have not yet been mandated to submit PLICS Acute data, and some elements of acute care such as critical care are not yet part of the PLICS Acute collection.

Historically the aggregate data collection was known as Reference Costs. From 2018-19, the patient level and aggregate collections are together referred to as the National Cost Collection (NCC).


Data combined to form NCC outputs

The NCC is currently the official source of costing data for NHS activity in England, and analysis from the collection is published by NHS England and NHS Improvement.

The sections of the NCC publication relating to acute activity will bring together PLICS Acute patient level data and the aggregate data to form single activity counts and cost totals.

For example, the statistics for admitted patient care (APC) episodes in the NCC publication are calculated using

  • PLICS Acute data for APC episodes that both started and ended in the financial year
  • aggregate data submitted to NHS England and NHS Improvement for episodes not included in the PLICS Acute collection, such as IVF
  • aggregate data for relevant episodes submitted to NHS England and NHS Improvement by providers in other sectors such as mental health

The interactive PLICS Portal made available to providers by NHS England and NHS Improvement includes PLICS data only.


Differences between this analysis and NCC published tables

For APC activity, the NCC publication tables include only episodes that both started and finished during the financial year, and therefore have all costs recorded in the 2018-19 data collection. Using episodes with only partial costs in the reporting year in analysis by Healthcare Resource Group (HRG) could produce misleading results.

In this report, overall activity counts and cost totals include all episodes, including those that started in a prior year, or continued at the year end.

However, analysis in this report using linked Hospital Episode Statistics (HES) data includes only episodes that finished during the financial year (they may have started in a prior year, or in the current year). This is because HES data for 2018-19 includes finished consultant episodes only.

(Please see the Linkage to HES section of this report regarding a relevant data quality issue).

Over 99% of PLICS Acute APC activity and over 97% of APC cost for 2018-19 was reported as relating to episodes that started and ended in the financial year.

The percentages of activity records and total costs reported as relating to each type of episode not wholly within the financial year were:

Episode type Percentage of PLICS Acute APC activity Percentage of PLICS Acute APC cost
Started prior to 1 April 2018 and ended by 31 March 2019 0.5 1.5
Started on or after 1 April 2018 and not ended by 31 March 2019 0.3 0.8
Started prior to 1 April 2018 and not ended by 31 March 2019 0.0001 0.01

The NCC publication tables exclude any activity with HRG code UZ01Z (Invalid for grouping) from all main analysis, and report on this activity separately.

All activity with submitted HRG code UZ01Z is included in this report for A&E, APC and outpatients, as the HRG code does not affect the type of analysis presented here.

The NCC publication tables and the PLICS portal for providers exclude APC and OP activity with submitted treatment function codes 264 (paediatric cystic fibrosis), 343 (adult cystic fibrosis services), 424 (well babies) and 700 (learning disability) as providers had been instructed by NHS England and NHS Improvement not to include activity in these areas in their PLICS Acute submissions.

This report includes activity under these four treatment function codes submitted by 32 providers. The relevant records comprise less than 0.05% of APC total activity and total cost, less than 0.01% of OP total activity and total cost and no more than 0.5% of APC or OP cost for any one provider.   

The NCC publication tables include separate analysis of high cost drugs and outpatient diagnostic imaging.

There is no separate reporting of these activities in this report.


Differences between this analysis and NCC outputs using linked HES data

Where a derivation such as a patient’s age could be obtained from either the PLICS Acute record or the linked HES record, this analysis uses the value from HES. NHS England and NHS Improvement outputs such as the PLICS Portal for providers may derive these values differently.



Last edited: 29 January 2020 2:16 pm