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Publication, Part of

Patient Level Activity and Costing, 2020-21

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Patient Level Activity and Costing, 2020-21


This report presents analysis of costing data for acute, mental health, Improving Access to Psychological Therapies (IAPT) and ambulance activity in 2020-21 submitted to the Patient Level Information and Costing System (PLICS) data collection by NHS providers in England. Acute data includes Emergency care (EC), Admitted patient care (APC), Outpatients (OP), Specialised ward care (SWC), and Supplementary Information (SI).

This is the first year that these datasets have been incorporated into a single integrated report, with previous releases focusing on individual settings.

The PLICS data collection is part of NHS England and NHS Improvement’s Costing Transformation Programme (CTP). The CTP aims to improve the quality of costing information in the NHS, and support providers to improve the efficiency of their services.

Acute costing data linked to activity present within the Hospital Episode Statistics (HES) data is reported, demonstrating the opportunities for richer analysis of costing data using the linked data. Linked data analysis for mental health and IAPT services will be developed for inclusion in future releases.

In order to respond to the challenges posed by the coronavirus pandemic the NHS in England were instructed to suspend all non-urgent activity for patients for parts of the 2020-21 reporting period. The timing and implementation of certain measures may also have varied geographically across England and will have impacted upon how and the extent to which these types of care activities were provided during this time which may need to be considered when interpreting the data.

These statistics are classified as experimental and should be used with caution. Experimental statistics are a series of statistics in the testing phase and not yet fully developed.

The data from the 2020-21 PLICS collection is used by NHS England and NHS Improvement in the National Cost Collection (NCC) publication. Information on how and why analysis in this report may differ from the NCC published analysis is included in the section Relationship to NHS England and NHS Improvement’s National Cost Collection outputs.

Key Definitions


Acute data includes data for the following feed types:

  • Emergency care (EC) - data relating to EC attendances in NHS hospitals, minor injury units and walk-in centres in England
  • Admitted patient care (APC) – data relating to patients admitted to NHS hospitals in England
  • Outpatients (OP) – data relating to appointments for non-admitted patient care as an outpatient
  • Specialised ward care (SWC) - data relating to adult, neonatal and paediatric critical care


Supplementary Information (SI)

  • SI data relating to high cost devices, high cost drugs and drug products and diagnostic imaging.  To note, costs for SI are distributed across both Acute and Mental Health


Mental Health (MH)

MH data includes data for the following feed types:

  • Mental Healthcare Contacts (MHCC) – data relating to non-admitted mental healthcare where a patient receives treatment
  • Provider Spells (MHPS) - data relating to a continuous period of time when a patient is admitted to a clinic or hospital for mental healthcare


Improving Access to Psychological Therapies (IAPT)

  • Data relates to appointments for assessment, treatment, and review delivered as part of the national IAPT programme. 



Ambulance data relates to calls made to the Ambulance Control Room that require one of the following:

  • Hear and Treat – clinical advice is provided, or the patient is referred to an appropriate service.  No ambulance trust vehicle or staff arrive at the scene
  • See and Treat - an emergency response arrives at the scene, and the patient is treated and discharged at the scene
  • See and Convey - an emergency response arrives at the scene, and one or more patients is conveyed by ambulance to a healthcare provider
  • Other Scenario – including hoax calls, incomplete and cancelled calls


To note

Some data has been excluded from the final reported figures.  Details are included in the How the data was collected section.

Key Facts

Acute - 141 providers reported a total cost of £56.5 billion, the majority of which relates to APC at £35.1 billion. The total cost covers around 14.4 million EC attendances, 14.3 million APC episodes, 66.3 million OP appointments and 2.3 million SWC days.

Supplementary Information (SI) - 143 providers reported a total cost of £2.6 billion.

Mental Health (MH) - 52 providers reported a total cost of £8 billion including: £4.1 billion relating to 17.4 million care contacts and £3.9 billion relating to hospital spells.

Improving Access to Psychological Therapies (IAPT) - 47 providers reported a total cost of £548.1 million relating to 4 million appointments.

Ambulance - 10 providers reported a total cost of £2.7 billion relating to 10.1 million incidents.

Last edited: 31 March 2022 9:36 am