Acute Patient Level Activity and Costing, 2019-20

This analysis uses the Patient Level Information and Costing System (PLICS) Acute data for 2019-20 collected between September and November 2020 by NHS Digital. This data was collected in compliance with a mandatory request from NHS England and NHS Improvement.

The timing of the collection was delayed from the provisional start date of July 2020 in the mandatory request in recognition of the impacts of the Covid-19 pandemic such as staff absence, redeployment and data delays which affected providers’ preparations to submit PLICS data.

The mandatory request lists the NHS providers identified by NHS England and NHS Improvement as required to submit PLICS Acute data for 2019-20. (Great Ormond Street Hospital for Children NHS Foundation Trust has since been removed from the list of providers required to submit.)

Non-NHS providers and NHS providers in other sectors that provide some acute services were not within the scope of this collection.

The PLICS Acute collection for 2019-20 included:

- Admitted patient care (APC)

- Outpatient (OP) attendances and procedures

- Accident and emergency (A&E) attendances

- Adult critical care

- High-cost drugs, blood products and devices, and unbundled outpatient diagnostic imaging

Full details of the services in and out of scope are available in the National Cost Collection guidance published by NHS England and NHS Improvement.

For APC episodes and adult critical care periods that spanned the start or end of the period (started in a prior financial year, or had not ended by 31 March 2020), costs relating to the bed days that fell within the financial year were included.

Each provider generated a PLICS Acute data extract using the costing data held on their local PLICS system, in accordance with the Information Standard.

For each activity such as an APC episode, the data submitted included an activity record (with identifiers to permit linkage to other data sets) and costs relating to that activity, split by a specified list of collection activities (such as ward care, pharmacy) and collection resources (such as doctors or nurses).

Providers used a tool published by NHS England and NHS Improvement to convert their data extract into files in the required format for submission, before uploading their PLICS Acute submissions to a secure NHS Digital portal. Resubmissions could be made, and the most recent submission for each provider was retained.

The NHS England and NHS Improvement conversion tool required all data items to be in the correct format and all mandatory fields to be populated to generate the files for submission. The tool also generated warnings for potentially incorrect data such as negative cost episodes for providers to review and improve data quality.

NHS England and NHS Improvement reviewed summary data from the PLICS Acute collection during the collection window. Submitting providers also received a summary report soon after making their submission.

Where data quality concerns were identified, NHS England and NHS Improvement asked the relevant providers to resubmit. Providers could also request permission to resubmit.

For providers that submitted close to the deadline, there will have been less opportunity to review data quality and arrange resubmission.

The latest submission from each provider was retained.

The A&E, APC and OP data from the set of latest submissions has been linked to Hospital Episode Statistics (HES) data for 2019-20 (the ‘Linkage to Hospital Episode Statistics’ section provides further details).

Following data quality checks by NHS England and NHS Improvement, data submissions from a small number of providers have been excluded from the data used in this report.

The PLICS Acute data for 2019-20 was pseudonymised and released to NHS England and NHS Improvement. This data will be used in the National Cost Collection outputs, the PLICS Portal for submitting NHS providers, and other tools and analysis.