Payment by Results
Payment by Results (PbR) is a system of paying NHS healthcare providers a standard national price or tariff for each patient seen or treated.
This tariff takes into account the complexity of the patient's healthcare needs and the tariff received by the provider is adjusted to reflect the nationally determined market forces factor (MFF). This is unique to each provider and reflects the fact that it is more expensive to provide services in some parts of the country than in others. There may also be other adjustments to the tariff for long or short stays, for specialised services, or to support other PbR policy changes.
PbR data for acute services is sourced from the Commissioning Data Sets (CDS), which are held within Secondary Uses Service (SUS) database - the same source as used for HES data. Like HES, PbR contains admitted patient care, outpatient and A and E datasets.
The difference between PbR and HES
PbR data is not cumulative
The HES extract is cumulative with the year to date being extracted each time. PbR data is not cumulative and simply takes two monthly snapshots at a given point in time (known as "flex" or "Reconciliation" and 'freeze' or "Post-Reconciliation"). After the "freeze" date, PbR never requires anextract of that same data again. This is in line with PbR policy which gives providers two months to submit the data before it is considered "frozen" to amendments. So in practice HES extracts April data and then April-May and then April-June and so on through the year whereas PbR data extracts April twice only and then May twice only and and so on.
PbR data is not subjected to additional processing
Unlike HES data that is subjected to additional processing to clean and de-duplicate the data. Further, the PbR data does not contain an array of added value calculated fields that appear in the HES data, such as alcohol fractions.
PbR data is based on spells that finished within the financial year
Unlike HES data that is based around episodes that finish in the financial year. Each spell (Hospital Provider Spell or HPS) is comprised of one or more episodes (Finished Consultant Episodes or FCEs). This means you will only see finished episodes when they are part of a completed spell. So if you have episodes within a long multi episode spell which spans a couple of years you might see some records in the HES data many months/years before they appear in the PbR data.
PbR data contains tariff information
This is the biggest benefit of the PbR data. Alongside activity, you can also produce cost analysis using these data which is an option not currently available with the HES data.
PbR data doesn't contain generic patient identifiers
So unlike the HES data, PbR data can't be linked to other data sets.
Should I choose HES or PbR data?
In principle if you need patient activity data including tariff information then you should request for PbR data, otherwise you should use HES.
For any questions related to PbR data please contact the HES PbR Data service.
Access national PbR data
Extracts and tabulations of national PbR data are available via NHS Digital's Data Access Request Service.