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Consultation on mandating
patient-level costing in the
mental health sector
November 2018
We support providers to give patients
safe, high quality, compassionate care
within local health systems that are
financially sustainable.
1 | Consultation on mandating patient-level costing in the mental health sector
Contents
About this document ...................................................................... 2
Scope of the consultation ............................................................... 3
What are we proposing? ................................................................ 6
Frequency of patient-level cost data collection ............................ 13
How we developed our proposal .................................................. 16
Annex 1: Patient-level costing consultation: glossary .................. 20
Annex 2: List of trusts covered by the proposal ........................... 21
2 | Consultation on mandating patient-level costing in the mental health sector
About this document
1. This consultation document proposes changes to the requirements on NHS
foundation trusts and NHS trusts who provide mental health services
1
to record
and report the costs of mental health activity. We propose that from 2019/20
the costs should be recorded and reported at a patient level, in line with the
methodologies and approaches in the Healthcare Costing Standards for
England (the standards). The changes would apply from the 2019/20 financial
year, with the first mandated collection in 2020.
2. Since 1 April 2016, Monitor and the NHS Trust Development Authority have
operated as a single organisation known as NHS Improvement. This document
is issued in accordance with the duty to consult imposed on Monitor by section
69(7) of the Health and Social Care Act 2012
2
. In this document ‘NHS
Improvement’ means Monitor, unless the context requires otherwise.
3. The document covers:
• what we propose to change
• options reviewed
• how we engaged with the sector in developing these proposals.
4. It should be read with the annexes and the supporting documents, especially
the impact assessment, available from the NHS Improvement website.
The document has been set up as a PDF form to allow you to enter your feedback
directly into the document. Questions are highlighted in boxes. You can also
provide your feedback through an online survey
3
.
To use the PDF form, you will need to use Acrobat Reader. If this is not already
installed, speak to your IT team or you can download it for free from:
https://get.adobe.com/uk/reader/
1
See Annex 2 for the current list of relevant trusts.
2
The duty to consult applies where section 69 requires Monitor to carry out an impact assessment of
proposals which are, among other things, likely to have a significant impact on providers of NHS
services.
3
https://engage.improvement.nhs.uk/pricing-and-costing/mandating-plics-mh
3 | Consultation on mandating patient-level costing in the mental health sector
Scope of the consultation
5. This is a statutory consultation in relation to the following proposal:
• For the financial year 2019/20 onwards, it would be mandatory for
designated NHS providers of mental health services to record and report
patient-level costs (PLC) in line with the Healthcare Costing Standards for
England (the standards).
• There would be up to no dual running of reference costs with reference costs
ceasing to be collected after 2018/19
6. The PLC data submission would cover all of the services currently collected
under reference costs
4
. To align with the process whereby mandation is
assessed by sector, the mandation timetable would be split for NHS mental
health providers. We have used the 2017/18 reference cost submission to
identify each trust’s main service and, as a result, when we expect they will be
required to submit patient-level costs for each type of service they provide
(acute, mental health, community or ambulance). The submission of PLC will
be subject to impact assessment and consultation of service-specific mandation
proposals, and approval by NHS Improvement’s Board. For details of when the
mandation would apply – see Annex 2.
7. Collecting PLC data is key to achieving the vision in the Five Year Forward
View (5YFV) and improving patient outcomes and efficiency. We described the
role of costing in supporting these wider objectives in our 2016 report, Patient-
level costing: case for change.
5
The plan for the transition to costing at a patient
level was set out in Improving the costing of NHS services: proposals for 2015
to 2021.
6
As part of this process, from 2018/19 the submission of PLC data has
been mandated in the acute sector (for designated trusts).
8. There has been a good level of engagement with the mental health sector in
this process as part of the process with over 20 NHS organisations, that
provide mental health services, on our Mental Health Technical Focus group to
4
Annex 10 of the impact assessment
5
https://improvement.nhs.uk/resources/plics-case-change/
6
https://www.gov.uk/government/consultations/improving-the-costing-of-nhs-services-proposals-for-
2015-to-2021
4 | Consultation on mandating patient-level costing in the mental health sector
draft and agree standards for costing
7
. In 2017/18, 21 trusts are planning to
submit PLC data voluntarily alongside the mandated reference cost return. At
the time of the impact assessment, there only 19% of trusts providing mental
health services
8
do not have a PLICS.
9. Our impact assessment indicates that mandating recording and submission of
PLC data using the standards would an impact (costs) but also have benefits to
trusts, commissioners and other users of the data
10. We have estimated there would be additional costs to trusts in implementing
PLC, over and above the cost of producing reference costs. On average we
have estimated the average cost to a trust of producing reference costs of
£36,820, compared to £40,481 for PLC. However, we believe the benefits of
mandating PLC outweigh the additional costs. Though PLC is not yet
embedded in this sector, some trusts are already identifying benefits, including
improving the quality and completeness of data being submitted. Other
expected benefits the sector expects to achieve include:
• enabling mental health trusts to compare patient pathways and costs with
peers, helping them reduce unwarranted variation
• improving understanding of patient pathways between mental health trusts
and the rest of the sector, facilitating new care models
• producing more accurate cost data that will improve the accuracy of the local
prices, helping to strengthen efficiency incentives and improve sustainability
across the service in the longer term.
11. This consultation invites you to feed back on the proposal to make PLC
mandatory for mental health services from 2019/20. We plan to publish our
response to the issues you raise and expect to make a final decision on the
proposal in February 2019. We will publish our decision on our website.
12. If you want to keep up to date with this work, please see our costing
newsletters and the costing mandation page on our website.
7
For more information see How we developed our proposal
8
This is 19% of those who would be mandated from 1 April 2019.
5 | Consultation on mandating patient-level costing in the mental health sector
Responding to this consultation
13. The proposal for the mandatory submission of PLC for mental health activity
from 2019/20 is subject to a statutory impact assessment and consultation
process, as required by Section 69 of the Health and Social Care Act 2012 (the
2012 Act). These processes offer stakeholders the opportunity to be informed
of the likely impact of the proposals and to tell NHS Improvement what they
think about them.
14. The consultation period begins on 30 November 2018 and ends on 11
January 2019.
15. We welcome feedback on the proposals and will consider your responses
before making a final decision on whether to mandate PLC for mental health
activity.
16. You can submit your feedback in two ways:
• completing the online survey: https://engage.improvement.nhs.uk/pricing-
and-costing/mandating-plics-mh
• answering the questions in this PDF, starting with the information
about you requested below, then saving the document and sending it to
costing@improvement.nhs.uk
17. Both surveys contain the same questions.
18. Please contact costing@improvement.nhs.uk if you need any more information.
About you
Name
Role
Organisation
Organisation type
(If other)
Please select from list
6 | Consultation on mandating patient-level costing in the mental health sector
What are we proposing?
Mandation
We propose that, for the financial year 2019/20 onwards, it will be mandatory
for NHS providers of mental health services to record and report costs at a
patient level for mental health activity in line with the Healthcare Costing
Standards for England. The mandation of reference costs will cease, with final
year of collection being 2018/19.
19. Trusts currently submitting reference costs using the datasets would be
required to record and report costs at a patient level. The methods and basis
for costing would follow the rules set out in the Standards
9
published as part of
the Approved Costing Guidance. Data would be submitted to NHS
Improvement after the end of the financial year.
20. This data would be recorded and reported by the relevant NHS trusts and NHS
foundation trusts (currently those noted in Annex 2) from the financial year
2019/20. The annual collection would take place after the end of the financial
year – the first currently planned for summer 2020, in relation to 2019/20
activity.
21. Currently cost data for mental health services is collected on an average basis
as part of reference costs, and the methods for calculating costs
10
have been
on a comply-or-explain
11
basis rather than required. This has led to issues and
differences in how costs are calculated, reducing the benefits for users from
benchmarking their costs and pathways. Inconsistencies and poor methods of
apportionment caused about half the inaccurate costing audit results over the
last three years.
22. The result is that this data, using average costs and differing methods of
apportionment, cannot easily be linked to an individual patient and can often
hide errors in how resources are allocated. Because of this, the data does not
9
https://improvement.nhs.uk/resources/approved-costing-guidance-standards/
10
Previously the Healthcare Financial Management Association Costing Standards, recently the
Healthcare Standards for England.
11
A regulatory approach used in the UK and other countries in corporate governance and financial
supervision. Rather than setting out binding laws, regulators set out a code, which listed companies
may either comply with, or if they do not comply, explain publicly why they do not.
7 | Consultation on mandating patient-level costing in the mental health sector
allow mental health providers to review and benchmark pathways internally or
with other providers. In addition, costing processes vary across organisations,
meaning there is no consistency in costing processes or methodologies,
impacting on the usefulness of data for comparison, both between trusts and
within organisations.
23. Our impact assessment indicates that, based on various types of trusts that
have already implemented PLC, more accurate costing would bring a range of
benefits, including the following:
• Supporting the provision of care in the best environment for patients,
as envisaged in the 5YFV. PLC would allow providers and commissioners
to use anonymised activity to identify patient pathways across all types of
providers – from ambulance to community settings. This could support plans
for integrated care across providers and contribute to a more joined-up and
preventive approach across NHS and other service providers.
• Improving comparison between peers – internally and with other
providers. Production of consistently costed activity will allow more accurate
benchmarking internally and with other providers which will allow
identification of cost variations across providers.
• Leading to better engagement with clinicians. Because PLC is at a
patient level and can be regularly produced, providers can share patient
pathway and cost data with staff outside of finance departments. This will not
only improve the accuracy of the data but will also allow mental health trusts
to work with other providers to improve treatment options. And linking to
outcome data will enable clinicians to better target interventions to support
people to manage conditions within the community.
• Allowing providers and sustainability and transformation partnerships
to assess the impact of changes in service provision. Many providers
have started to use patient-level data understand the profitability of services.
One trust has found issues with the accuracy of activity data by comparing
costs and activity across services and is using initial PLC data to ensure all
activity is being correctly recorded and identified for costing purposes.
• Providing more accurate data for agreeing local prices and local
variations to national prices. In the past, prices have often been based on
a provider’s average costs. However, detailed costs at a patient level, which
have been validated by clinicians and commissioners, would give a more
accurate basis for agreeing prices.
8 | Consultation on mandating patient-level costing in the mental health sector
24. We have estimated the costs of implementing and running PLC systems as part
of our impact assessment. Unlike the acute sector, as PLC is only just being
implemented in mental health, most of the benefits are expected rather than
being realised. As noted, one trust has used initial PLC data to identify issues
with the recording and counting of activity by comparing costs and activity
across similar teams. Benefits those implementing PLC expect to achieve
include:
• being able to cost across all services in a consistent manner (even where
the service is a commercially let contract and cost information is not
collected). This will reduce time spent on business cases and bidding for
contracts as cost information will be readily available
• producing more accurate information to identify cost or savings
improvements, or business cases for service changes.
25. By mandating the methods and approaches for costing according to the
standards we can ensure consistent costing, which would support
benchmarking of costs and job cycles.
How would PLC recording and reporting be made mandatory?
26. The standard conditions of the NHS provider licence
12
contain provisions
relating to pricing, including requirements on recording and reporting
information about costs – see conditions P1 and P2. The licence applies to
NHS foundation trusts; NHS trusts are required to comply with equivalent
conditions, including the requirements relating to pricing and costs.
27. The conditions require trusts to:
• record cost information in accordance with cost allocation methodologies
published by NHS Improvement in its Approved Costing Guidance (condition
P1)
• provide such information, documents and reports relating to costs as NHS
Improvement may require for its pricing functions (condition P2).
28. These requirements apply if the relevant providers are notified in writing – we
notify providers by publishing the relevant requirements in our costing
guidance.
12
https://www.gov.uk/government/publications/the-nhs-provider-licence
9 | Consultation on mandating patient-level costing in the mental health sector
29. The proposal to mandate PLC recording and reporting would be implemented
by including the applicable requirements, methodology and standards in
guidance published by NHS Improvement in advance of the financial year
2019/20 (likely to be January 2019).
30. This would mean that trusts would have duties to record and report costs in
accordance with the standards. Failure to comply with those duties would be a
breach of the relevant conditions, which might result in regulatory action by
NHS Improvement, including, in appropriate cases, use of its statutory
enforcement powers.
Issues and risks of the proposal
31. This proposal is a significant change in how costs are recorded and reported
across trusts. Implementing PLC raises several issues. Table 1 summarises
these issues and sets out the mitigation or rationale for our decision.
Table 1: Obstacles to implementing PLC
Issue
Mitigation or rationale
The new standards are very
detailed, and some trusts are
concerned they do not currently
have all the expected
information to fully implement
the new approaches.
For the financial year 2017/18, we expect 21
mental health trusts (39% of non-
acute/community providers) to submit PLC data.
We expect this to increase the following year
2018/19 (collected in 2019), including extending
this to acute providers who also provide mental
health services (14 trusts currently).
We will continue to work with the Mental Health
Technical Focus Group (TFG) to identify trusts
that need additional support and identify
whether a transition pathway, similar to that for
acute, is required for those trusts who are not as
advanced as others. We will also consider, with
the TFG, the creation of an implementation
timetable to support trusts implementing PLC.
The accuracy of underlying data
has not been verified, and the
cost of introducing PLC may not
lead to sufficient benefits to
recoup the costs.
We believe that PLC will improve the accuracy
of data collected by providers and will allow
trusts to compare productivity and patient
pathways, both internally and externally, to
identify where processes can be improved. It will
also allow mental health providers to link in and
be part of conversations on future plans for
providing health services across areas.
10 | Consultation on mandating patient-level costing in the mental health sector
Question
To what extent do you agree with mandating patient-level data for mental
health services in line with the methodologies and approaches in the
Healthcare Costing Standards for England, from 2019/20?
Strongly
agree
Agree
Neither
agree or
disagree
Disagree
Strongly
disagree
What is the reason for your answer?
Ceasing the collection of reference costs
To support the implementation of PLC, we propose ceasing the collection of
reference costs, with the last year being 2018/19.
32. We believe that ceasing the collection of average reference cost data will not
only reduce the burden on the small costing teams in mental health trusts but
will also hasten the implementation and use of PLC as the single version of
cost data by providers, commissioners and other data users.
33. We believe that having a single consistent method of recording activity (and
associated costs) will be extremely beneficial, as it will focus on PLC becoming
the only source of costing data. We are also confident that, should it be
required, we would be able to recreate reference cost data from PLC.
34. There are a number of risks and issues with this proposal. We have included
these, and the mitigation or rationale for our decision, in Table 2:
Table 2: Dual collection issues
Issue
Mitigation or rationale
Reference cost data is used as
the basis for local prices and
moving to PLC may impact on
We will be making data from the voluntary PLC
collections for 2017/18 and 2018/19 available to
early implementer trusts as part of the PLICS
portal. We will also work with NHS England and
11 | Consultation on mandating patient-level costing in the mental health sector
Issue
Mitigation or rationale
agreeing prices with
commissioners.
This was noted during the
impact assessment work. Those
trusts not on block contracts
have been using various costing
processes to calculate and
agree local prices.
the Mental Health Technical Focus Group to
support the move away from reference costs for
pricing and contracting purposes, including
providing guidance to commissioners on how to
use the aggregated PLC data published.
The accuracy of underlying data
may impact on contracting
arrangements.
As noted above, we believe the accuracy of
data will be improved by moving to PLC. We will
continue to work with trusts and other users of
the data to refine and improve costing, using the
PLICS portal and the costing assurance
programme to improve the accuracy of data.
Information for contracted-out
(outsourced patient activity)
work has previously been
included in reference costs but
has been excluded since
2017/18.
Outsourced activity remains excluded as this is
not currently available at a patient level. We are
asking trusts to start working with their providers
to obtain this at the required level. We will
continue to work with the sector as part of the
costing transformation programme, with the aim
to reduce exclusions from the quantum.
Question
Do you agree with the proposal to cease collection of reference costs for
mental health activity from 2018/19?
Yes
No
If you disagree, why do you disagree?
Is there an alternative? Please provide details of what you propose.
12 | Consultation on mandating patient-level costing in the mental health sector
35. Because of how each organisation has structured its internal finance process,
we have only included an estimated cost of producing the required cost return -
whether this reference costs or PLC. For example, some providers include the
cost of producing service line reporting and other cost data as part of their
costing function and others exclude this. Therefore, we have estimated the cost
of producing a costing return (including collecting the relevant data, calculating
and verifying costs and senior review and sign off) based on information
collected from previous reference costs surveys and on-site visits and data
provided by trusts and excluded the costs of internal financial functions.
Question
Do you have any comments on our assessment of the likely costs?
13 | Consultation on mandating patient-level costing in the mental health sector
Frequency of patient-level
cost data collection
36. Though we are not currently recommending collection of PLC data more
frequently than annually, we would like to use this opportunity to invite
comments from trusts and other users of reference cost data.
37. Currently, costing data is collected annually. In trusts, financial data is produced
more frequently – often quarterly. Producing and collecting cost data on a more
regular basis would, initially, increase the burden on trusts. However, this would
be spread over the year and we believe the overall increase would be limited.
38. Feedback from the acute consultation indicated that this would be beneficial,
but that certain issues and processes would need to be addressed prior to
rolling this out.
39. We believe collecting PLC data more frequently would benefit all providers and
other users. For all trusts these benefits include:
• identifying issues with costing during the year rather than after the year-end,
allowing correction and more accurate costs to be submitted
• supporting the financial management process as cost and activity
information is available more frequently; this data will enable trusts to identify
and address issues on a more timely basis.
40. For other users, we believe:
• it would further the work of, for example, the Model Hospital and Group
Advising on Pricing Improvement (GAPI) as metrics could be run more
frequently, allowing them to support providers in a more timely manner
• it may reduce information collected by NHS Improvement – for instance,
data on costs and activity could reduce the information trusts must collect as
part of quarterly reporting, and it would help in agreeing financial targets and
cost improvement plans.
14 | Consultation on mandating patient-level costing in the mental health sector
Issues and risks of the proposal
41. As with our other proposals, we have identified issues and risks. Table 3
summarises these and explains the mitigation or rationale for the proposal.
Table 3: Frequency of collection issues
Issue
Mitigation or rationale
Moving to quarterly collection
would increase the burden on
providers’ costing and finance
staff and reduce the time
available to investigate and
review PLC within trusts.
The burden would increase initially, but much of
the validation and investigation that happens at
the year-end would be spread throughout the
year.
We also believe that:
• more frequent collection of cost data would
link better with trusts’ internal reporting
arrangements and therefore better support
internal financial monitoring
• the data can be used to support
commissioning and reduce time spent
investigating queries
• it will help identify cost saving plans – and
costs that differ from expectations – more
quickly.
What would quarterly data be
used for?
We could regularly publish data validation reports
and outlier information, to help trusts improve the
accuracy of their data during the year.
It could also be used to assess the impact of
casemix changes during the year.
15 | Consultation on mandating patient-level costing in the mental health sector
Question
Do you agree patient-level costing returns should for the mental health
sector, in time, be submitted quarterly?
Strongly
agree
Agree
Neither agree
or disagree
Disagree
Strongly
disagree
What is the reason for your answer?
If you agree, when would it be realistic to make this a requirement?
2021/22
2022/23
2023/24 or later
Please give details of any other risks or issues you feel need to be
addressed to support the move towards quarterly collection of PLC data
Do you have any other views or comments to make on the proposals?
16 | Consultation on mandating patient-level costing in the mental health sector
How we developed our
proposal
History
42. Cost data is recorded and reported by NHS trusts and NHS foundation trusts
under NHS Improvement (Monitor) requirements for the provider licence. This
information has a variety of users – for example:
• trusts and commissioners use reference costs to manage their costs, agree
local contracts and prices, and plan future services
• NHS Improvement uses reference cost as the basis for pricing, including the
national tariff
• cost data supports a wide variety of cross-sectoral work to improve clinical
outcomes and efficiency, including the work on operational productivity led
by Lord Carter and benchmarking trusts to identify unwarranted cost
variation.
43. The processes for submitting reference costs – and their accuracy – vary
considerably between trusts. In 2016/17 we undertook an initial audit at 19
mental health trusts and in 68% of audits the level of assurance over accuracy
of cost data submitted was limited or no assurance. This is supported by the
findings from NHS Improvement’s Mental Health Technical Focus Group, set
up to support the move to PLICS, which found large variances in how people
collect and costed mental health activities.
44. We published several documents to support our plans: Patient-level costing:
case for change
13
and Improving the costing of NHS services: proposals for
2015 to 2021.
14
The latter introduced the costing transformation programme
(CTP). By 2020 the CTP aims to address inconsistency and improve costing
across the NHS.
13
https://improvement.nhs.uk/resources/plics-case-change/
14
https://www.gov.uk/government/consultations/improving-the-costing-of-nhs-services-proposals-for-
2015-to-2021
17 | Consultation on mandating patient-level costing in the mental health sector
45. In preparation for a proposed move to PLC, many trusts have already been
involved in piloting PLC through voluntary collections. Of the 54 trusts which
are mainly mental health trusts, 81% have or are procuring a costing system
and we expect all trusts to have a system in place to produce a return for
2019/20.
46. Mandating PLC and ceasing to collect reference cost data is likely to have a
significant impact on trusts. Therefore, we are required by the 2012 Act to
undertake an impact assessment of the changes, looking at the costs and
benefits of various options. The next section summarises the impact
assessment, which is available on our website.
Impact assessment summary
47. Initially we identified eight options for mandating PLC (see impact assessment
document for more information), and investigated three in detail:
• Option 1 (business as usual): reference costs remain the mandated costing
return, but we continue with a voluntary PLC submission; the standards
remain on a comply-or-explain basis
• Option 2: mandating PLC for mental health activity from 2019/20, with up to
a two-year dual running of reference costs; mandating standards for costing
for both PLC and reference costs from 2019/20
• Option 3: as Option 2 above, but ceasing collections of reference costs after
the 2018/19 financial year.
48. As part of the impact assessment we interacted with trusts by:
• reviewed the findings of a survey, completed in summer of 2018. This was
completed by 48 trusts and collected data on
– number of trusts with/procuring costing systems
– time spent completing reference cost submissions
– requirement for additional resources and
– identification of areas where trusts may not be able to collect data
currently required in draft healthcare costing standards
• collecting and reviewing business cases from trusts currently or recently
implementing PLC
18 | Consultation on mandating patient-level costing in the mental health sector
• collecting information from 13 trusts – either through on-site meetings or
telephone conference, all at different stages of their PLC journeys to discuss
the risk, benefits and costs of implementing PLC
• feedback initial findings from the impact assessment to the Mental Health
Technical Focus Group (TFG) in October 2018 to identify any areas we have
not covered
• met other key users of reference cost data to understand the impact of the
proposed change on their work and identifying the risks and benefits of
various options.
49. We used our findings to assess what we consider to be the best option for our
proposals and identify its potential benefits. Feedback from trusts implementing
PLC identified many benefits – some of which they were already achieving and
others expected. These include:
• more granular information, which will enable trusts to review unwarranted
clinical variation by patient, which, in turn, will allow better benchmarking,
both internally and across the sector, to identify innovative ways of providing
services
• improving the completeness and accuracy of activity data by providing more
granular information which can be verified on a regular basis with clinician
staff
• more detailed information on clinical pathways, which can be used to
improve procedures, especially when SNOMED codes start to be collected
from 2020/21 onwards
• future planned links to clinical outcomes will support service redesign by
identifying where patients could have been more appropriately treated.
• clearer and more consistent apportionment of overheads and better
understanding of cost drivers across the trust.
50. For reach of the options, we used data collected through on-site discussions
and from trusts to calculate the average cost of running patient-level costing
and information systems – see Table 4. Considering this, along with the
benefits and risks, we found that option 3 was the preferred option.
19 | Consultation on mandating patient-level costing in the mental health sector
Table 4: Summary of estimated cost for each option
Year
Option 1
Option 2
Option 3
2018/19
48,454
£70,088
£70,088
2019/20
37,476
£58,387
£31,574
2020/21
34,045
£57,285
£31,131
2021/22
33,039
£36,140
£36,140
2022/23
31,863
£35,613
£35,613
2023/24
33,365
£36,852
£36,852
2024/25
34,938
£38,563
£38,563
2025/26
36,586
£40,440
£40,440
2026/27
38,312
£42,230
£42,230
2027/28
40,119
£42,176
£42,176
Total
£368,197
£457,773
£404,806
51. Though the costs of option 1 and 3 are broadly similar, feedback from most
mental health providers and other users of data, such as Getting It Right First
Time (GIRFT), Model Hospital (Carter Team) and other regulators, indicate that
the benefits of Option 3 much outweigh those for Option 1 (business as usual).
52. As well as generating the benefits noted above, we believe there would be
additional cost savings from reducing time spent producing bids for commercial
tenders for activities which are often let commercially by commissioners. We
also believe that other regulators and other national bodies (such as the
National Audit Office) would, subject to information governance arrangements,
be able to use the activity data as the single version of the truth on
performance, which would reduce information requests in the future.
53. More information on the detailed assumptions and benefits can be found in the
impact assessment.
20 | Consultation on mandating patient-level costing in the mental health sector
Annex 1: Patient-level
costing consultation:
glossary
Term
Description
2012 Act
The Health and Social Care Act 2012.
Costing transformation
programme (CTP)
Aims to improve the quality and use of costing
information in the NHS, with patient-level costing and
a single, national annual cost collection.
Healthcare Costing
Standards for England (the
Standards)
The approved approaches and methodologies for
calculating costs, published in the Approved Costing
Guidance
Patient-level costing (PLC)
Calculating and collecting data at an individual
patient level.
Patient-level information
and costing system
(PLICS)
The system used to record and report costs at a
patient level.
Reference costs
The average unit cost to the NHS of providing health
care to NHS patients.
21 | Consultation on mandating patient-level costing in the mental health sector
Annex 2: List of trusts
covered by the proposal
Trusts that would be covered by mental health mandation from 2019/20
Org
Code
Trust
RTQ
2GETHER NHS FOUNDATION TRUST
RBS
ALDER HEY CHILDREN'S NHS FOUNDATION TRUST
RVN
AVON AND WILTSHIRE MENTAL HEALTH PARTNERSHIP NHS TRUST
RRP
BARNET, ENFIELD AND HARINGEY MENTAL HEALTH NHS TRUST
RWX
BERKSHIRE HEALTHCARE NHS FOUNDATION TRUST
RXT
BIRMINGHAM AND SOLIHULL MENTAL HEALTH NHS FOUNDATION
TRUST
RQ3
BIRMINGHAM WOMENS AND CHILDREN'S HOSPITAL NHS
FOUNDATION TRUST
TAJ
BLACK COUNTRY PARTNERSHIP NHS FOUNDATION TRUST
RXL
BLACKPOOL TEACHING HOSPITALS NHS FOUNDATION TRUST
RMC
BOLTON NHS FOUNDATION TRUST
TAD
BRADFORD DISTRICT CARE NHS FOUNDATION TRUST
RT1
CAMBRIDGESHIRE AND PETERBOROUGH NHS FOUNDATION TRUST
TAF
CAMDEN AND ISLINGTON NHS FOUNDATION TRUST
RV3
CENTRAL AND NORTH WEST LONDON NHS FOUNDATION TRUST
RXA
CHESHIRE AND WIRRAL PARTNERSHIP NHS FOUNDATION TRUST
RFS
CHESTERFIELD ROYAL HOSPITAL NHS FOUNDATION TRUST
RJ8
CORNWALL PARTNERSHIP NHS FOUNDATION TRUST
RYG
COVENTRY AND WARWICKSHIRE PARTNERSHIP NHS TRUST
RNN
CUMBRIA PARTNERSHIP NHS FOUNDATION TRUST
RXM
DERBYSHIRE HEALTHCARE NHS FOUNDATION TRUST
RWV
DEVON PARTNERSHIP NHS TRUST
RDY
DORSET HEALTHCARE UNIVERSITY NHS FOUNDATION TRUST
RYK
DUDLEY AND WALSALL MENTAL HEALTH PARTNERSHIP NHS TRUST
RXR
EAST LANCASHIRE HOSPITALS NHS TRUST
RWK
EAST LONDON NHS FOUNDATION TRUST
22 | Consultation on mandating patient-level costing in the mental health sector
Org
Code
Trust
R1L
ESSEX PARTNERSHIP NHS FOUNDATION TRUST
RR7
GATESHEAD HEALTH NHS FOUNDATION TRUST
RXV
GREATER MANCHESTER WEST MENTAL HEALTH NHS FOUNDATION
TRUST
RWR
HERTFORDSHIRE PARTNERSHIP UNIVERSITY NHS FOUNDATION
TRUST
RQX
HOMERTON UNIVERSITY HOSPITAL NHS FOUNDATION TRUST
RV9
HUMBER NHS FOUNDATION TRUST
R1F
ISLE OF WIGHT NHS TRUST
RXY
KENT AND MEDWAY NHS AND SOCIAL CARE PARTNERSHIP TRUST
RW5
LANCASHIRE CARE NHS FOUNDATION TRUST
RGD
LEEDS AND YORK PARTNERSHIP NHS FOUNDATION TRUST
RT5
LEICESTERSHIRE PARTNERSHIP NHS TRUST
RP7
LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST
RW4
MERSEY CARE NHS FOUNDATION TRUST
RRE
MIDLANDS PARTNERSHIP NHS FOUNDATION TRUST
RMY
NORFOLK AND SUFFOLK NHS FOUNDATION TRUST
RAT
NORTH EAST LONDON NHS FOUNDATION TRUST
RLY
NORTH STAFFORDSHIRE COMBINED HEALTHCARE NHS TRUST
RTV
NORTH WEST BOROUGHS HEALTHCARE NHS FOUNDATION TRUST
RP1
NORTHAMPTONSHIRE HEALTHCARE NHS FOUNDATION TRUST
RX4
NORTHUMBERLAND, TYNE AND WEAR NHS FOUNDATION TRUST
RTF
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
RHA
NOTTINGHAMSHIRE HEALTHCARE NHS FOUNDATION TRUST
RNU
OXFORD HEALTH NHS FOUNDATION TRUST
RPG
OXLEAS NHS FOUNDATION TRUST
RT2
PENNINE CARE NHS FOUNDATION TRUST
RXE
ROTHERHAM DONCASTER AND SOUTH HUMBER NHS FOUNDATION
TRUST
RCU
SHEFFIELD CHILDREN'S NHS FOUNDATION TRUST
TAH
SHEFFIELD HEALTH & SOCIAL CARE NHS FOUNDATION TRUST
R1C
SOLENT NHS TRUST
RH5
SOMERSET PARTNERSHIP NHS FOUNDATION TRUST
RV5
SOUTH LONDON AND MAUDSLEY NHS FOUNDATION TRUST
23 | Consultation on mandating patient-level costing in the mental health sector
Org
Code
Trust
RE9
SOUTH TYNESIDE NHS FOUNDATION TRUST
RQY
SOUTH WEST LONDON AND ST GEORGE'S MENTAL HEALTH NHS
TRUST
RXG
SOUTH WEST YORKSHIRE PARTNERSHIP NHS FOUNDATION TRUST
RW1
SOUTHERN HEALTH NHS FOUNDATION TRUST
RXX
SURREY AND BORDERS PARTNERSHIP NHS FOUNDATION TRUST
RX2
SUSSEX PARTNERSHIP NHS FOUNDATION TRUST
RNK
TAVISTOCK AND PORTMAN NHS FOUNDATION TRUST
RX3
TEES, ESK AND WEAR VALLEYS NHS FOUNDATION TRUST
RKE
THE WHITTINGTON HOSPITAL NHS TRUST
RA9
TORBAY AND SOUTH DEVON NHS FOUNDATION TRUST
RKL
WEST LONDON MENTAL HEALTH NHS TRUST
R1A
WORCESTERSHIRE HEALTH AND CARE NHS TRUST
Trusts that would covered by mental health mandation – from 2020/21
15
Org
Code
Trust
RY2
BRIDGEWATER COMMUNITY HEALTHCARE NHS FOUNDATION
TRUST
RY4
HERTFORDSHIRE COMMUNITY NHS TRUST
RY6
LEEDS COMMUNITY HEALTHCARE NHS TRUST
R1D
SHROPSHIRE COMMUNITY HEALTH NHS TRUST
RDR
SUSSEX COMMUNITY NHS FOUNDATION TRUST
15
See paragraph 6
© NHS Improvement 2018 Publication code: C 07/17
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