Patient Level Activity and Costing, 2020-21

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.

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).

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 initial NCC publication relating to activity will bring together PLICS patient level data and some aggregate data for activity submitted to NHS England and NHS Improvement to form single activity counts and cost totals.  Please refer to the initial NCC publication for full details of the data included in the initial release.

The final NCC publication will bring together the PLICS patient level data and all relevant aggregate data from all sectors.  For example, the statistics for Admitted patient care (APC) episodes in the final NCC publication are calculated using:

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

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

This section covers differences related to Acute data.

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 2020-21 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 2020-21 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 98% of APC cost for 2020-21 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:

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 EC, APC and OP, as the HRG code does not affect the type of analysis presented here.

Where a derivation such as a patient’s age could be obtained from either the PLICS 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.