Contents

  • Cost by mapping pot for example Non elective, Outpatient, Mental Health etc
  • Cost by Department for example Consultant led, Outpatient etc
  • Cost by service for example Ophthalmology, Obstetrics etc
  • Cost by HRG showing all HRG codes for the previously selected options.
  • Actual cost by provider for the ICB selected give all trusts, number of items and total cost
  • Unit cost of selected activity gives the unit cost by trust to all for comparison
 

Activity & Costs Admitted Patient Activity and Acuity

  • Cost by HRG Chapter for example Cardiac, Obstetrics etc
  • Cost by Sub Chapter relating to the HRG Chapter selected
  • Cost by HRG Description relating to previous choices
  • Cost by Acuity which then enables more precise comparison between trusts within an ICS
  • Actual cost of inpatient Services by provider for the ICB selected gives all trusts, number of items and total cost
  • Unit cost of selected activity gives the unit cost by trust to all for comparison
 

Sources

NHS England
National Cost Collection

Glossary Activity and Costs

Term

Meaning

Activity

All patient activity is allocated a HRG Code which can then be reported on.  In this instance activity relates to one single occurrence of this code.

Acuity

Acuity is part of the information captured in an HRG code/description, for example –

Very Major Hip Procedures for Trauma with CC Score 12+

Very Major Hip Procedures for Trauma with CC Score 9-11

Very Major Hip Procedures for Trauma with CC Score 6-8

Very Major Hip Procedures for Trauma with CC Score 3-5

Very Major Hip Procedures for Trauma with CC Score 0-2

The CC score relates to the complexity level which is calculated for each treatment episode to indicate the effect of complications and comorbidities in a patient. The higher the number the more complex the procedure.

Cost

This report is based upon the National Cost Collection which comprises aggregated costs (the average unit cost of providing defined services to NHS patients in England) and patient-level costs/PLICS (a cost based on the specific interactions a patient has, and the events related to their healthcare activity).

HRG

Healthcare Resource Groups (HRGs) are standard groupings of clinically similar treatments which use comparable levels of healthcare resource.

HRG Chapter

HRG Chapters are a summary group within the HRG Item List. 
These are –

A Nervous system

B Eyes and periorbita

C Mouth head neck and ears

D Respiratory system

E Cardiac surgery and primary cardiac conditions

F Digestive system

G Hepatobiliary and pancreatic system

H Musculoskeletal system

J Skin, breast and burns

K Endocrine and metabolic system

L Urinary tract and male reproductive system

M Female reproductive system and assisted reproduction

N Obstetrics

P Diseases of childhood and neonates

Q Vascular system

R Radiology and nuclear medicine

S Haematology, chemotherapy, radiotherapy and specialist palliative care

U Undefined groups

V Multiple trauma, emergency medicine and rehabilitation

W Immunology, infectious diseases and other contacts with health services

X Critical care and high cost drugs

 

HRG Description

The HRG description will contain all elements of the procedure, for example – Where the code is HT12A for Very Major Hip Procedures for Trauma with CC Score 12+ the various elements in the code will equate to the subsequent description.

ICB

Integrated care systems (ICSs) are partnerships that bring together NHS organisations, local authorities and others to take collective responsibility for planning services, improving health and reducing inequalities across geographical areas.  England is split into 42 ICS’s.  Each ICS has an associated Integrated Care Board (ICB) which was previously known as CCG’s (Clinical Commissioning Groups).

Inpatient Services

Inpatient treatment is any treatment that requires you to stay overnight in a hospital or clinic for at least one night.

Items

In this instance “items” related to patient record data items, such as procedures, diagnoses, age and length of stay are used to determine the appropriate HRG code..

Mapping Pot

All entries have a code allocated to them which is one of 13 groups. The code is Up to 7 character code – e.g. ‘01_EI’. ‘01’ refers to pot 1, EI is a description of the pot – Elective Inpatient.

Service

Service is the name of the hospital service responsible for the activity e.g. General Surgery

Sub Chapter

The Sub Chapter is part of the overall HRG Code.  Where the code is HT12A for Very Major Hip Procedures for Trauma with CC Score 12+, the second letter (T) in this case relates to the for Trauma element in the description.

Total Cost

Total Cost is the cost per instance multiplied by the Cost.

Trust

An NHS Trust is an organisation. An NHS Trust is a legal entity, set up by order of the Secretary of State under section 25 of, and Schedule 4 to, the National Health Service Act 2006, to provide goods and services for the purposes of the health service.  A Trust is part of an ICS.

Unit Cost

See Cost