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HRG4+ 2019/20 Consultation Grouper

Summary

The Consultation Grouper has been developed to support NHS England and NHS Improvement’s National Reimbursement System proposals for use in 2019/20.

Download the HRG4+ 2019/20 Consultation Grouper application

Before using the Grouper, please read the Summary of Changes document to understand the updates to both the product and underlying design. The Grouper User Manual provides full instructions on how to prepare and group data using the updated Groupers.  

The Grouper does not apply certain tariff business rules; for example, pre-processing exclusions, tariff exclusions and Prescribed Specialised Service flagging. PSS flags are used to apply reimbursement top-ups where applicable and as a result the Grouper no longer outputs SSC flags. 

Download documents

Summary of Changes – this Summary of Changes document provides an overview of the main changes to the underlying design between the HRG4+ 2019/20 Engagement Grouper and the HRG4+ 2019/20 Consultation Grouper. 

Grouper User Manual - this document provides full instructions on how to prepare and group data using the updated HRG4+ Grouper software application, as well as illustrating how the revised product can be used to support users.

Test data and expected results – these files provide sample data to test the Grouper installation (running the sample data should result in 90% grouped, 10% ungrouped). The file format of the sample data is representative of that in the default RDFs, provided within the Grouper application. These files can easily be used as example patient data, or as a template to understand the required input to the Grouper to enable successful grouping. 

Casemix Companion - this document is a starting point and general reference guide for anyone interested in learning about the casemix classification system used by the NHS in England. It provides an introduction to HRGs, Groupers, HRG4+ design concepts and grouping logic, and it contains links to additional resources.

Chapter Summaries - this document provides an overview of the scope, composition and grouping logic of individual subchapters, including the update to the HRG design.

Code to Group  - this workbook provides details of constituent elements that contribute to HRG grouping. It contains reference data, such as the ICD-10 and OPCS-4 codes used in the design, procedure and diagnosis hierarchies relevant to a specific design, and the Complication and Comorbidities lists for HRG subchapters. It also includes information on Programme Budgeting Category (PBC) mapping and a comprehensive list of HRG codes and labels.

Guide to Best Practice Flags - this workbook contains details of the logistics of how the Grouper allocates specific identification flags relating to best practice.  Note that in line with national reimbursement policy proposals, Same Day Emergency Care (SDEC) best practice  flags have been removed from the Consultation product.

 

Get involved

To get involved in the future product development as a beta tester, or if you have ideas or feedback on the current product, please contact julie.speller@nhs.net.

Further information

For more details about the statutory consultation notice for 2019/20, please visit NHS Improvement

Archive material

Visit our archive to view downloaded historical versions of Groupers and documentation

Last edited: 4 March 2019 2:50 pm