Payment by Results guidance

Inclusion Date: Deadline for data submissions to be included in the frozen views of data.

Publication Date: Guaranteed SUS+ publication date for all inclusion extracts run on the inclusion day, inclusion +1 day and inclusion +2 days, by 8am on the day.

SUS+ provides for a two phase reconciliation process to arrive at a final agreed position for each month's activity as defined in the NHS Standard Contract.

In the first phase of reconciliation, providers submit initial calendar month activity data to SUS+.

At a nationally determined deadline (Inclusion date), a snapshot of this data is taken. The point at which this first snapshot is taken is referred to in SUS+ as the Reconciliation point. The NHS Standard Contract uses the term First Reconciliation Date for the point at which this first snapshot is available from SUS+.

Under the contract, providers will base the first reconciliation account they send to commissioners on the first-phase reconciliation data they submit to SUS+ by the Reconciliation Inclusion date above.

In the second phase, providers and commissioners review and validate the data submitted in the first phase with the aim of agreeing the final level of payment to be made for the period. At a second nationally determined inclusion date a second snapshot of the data is taken. This second snapshot point is referred to in SUS+ as the Post-reconciliation point. The NHS Standard Contract uses the term Final Reconciliation Date for the point at which the data in this snapshot is processed and available.

Under the contract, providers base the final reconciliation account they send to commissioners on this second-phase reconciliation data which they submit to SUS+ by the Post-Reconciliation Inclusion date.

Once the provider has sent the final reconciliation account, the contract then allows the commissioner a brief period to validate the final data and contest any elements of the final reconciliation account which it believes are incorrect via the process set out in the contract.