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HRG4+ 2019/20 Local Payment Grouper
The HRG4+ 2019/20 Local Payment Grouper has been developed to be used in line with the National Reimbursement System, as produced by NHS England and NHS Improvement.
HRG4+ 2019/20 Local Payment Grouper application
The Local Payment Grouper should be used to:
- group data and derive HRGs
- support data quality
- conduct what-if modelling
- assess local reimbursement that will be received under the National Tariff for the 2019/20 financial year
It should be used in conjunction with the Grouper User Manual, which explains how data should be sorted and presented for processing by the Grouper.
As with previous releases, users must be aware that the Grouper does not apply certain tariff business rules; for example, Prescribed Specialised Service flagging, which are now used to apply reimbursement top-ups where applicable.
Activities relating to Treatment Function Code or other pre-processing exclusions should also be removed from the input data before running through the Local Grouper. As HRG exclusions are at spell level, and the HRG4+ Grouper produces both episode and spell-level HRGs during the same run, HRG exclusions should be made at spell level following grouping. There is no requirement to group data twice. Organisations choosing not to remove exclusion data may generate HRGs that are excluded from national tariff under national funding policy.
Summary of Changes – this document summarises the updates to both the product and underlying design against the last Local Payment product release. Users are advised to read before using the latest Grouper.
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.
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.
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.
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.
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 email@example.com.
For more details about the National Tariffs for 2019/20, please visit NHS Improvement.
Visit our archive to view downloaded historical versions of Groupers and documentation