Costing Award

Sponsored by

This award focuses on improvements in costing processes and costing information that have led better information for organisations to use when make decisions about service delivery.

Winner Cardiff and Vale University Health Board

Also shortlisted Chelsea and Westminster Hospital NHS Foundation Trust; Liverpool Heart and Chest Hospital NHS Foundation Trust

Cost right
Cardiff and Vale University Health Board’s drive to improve the understanding of costs – including the implementation of patient level costing (PLC) – has clinched it the inaugural HFMA Costing Award.
The decision to adopt PLC was taken to allow budget holders and clinical managers to gain a greater understanding of their use of resources and to move away from focusing on managing variances from a budget.
Given the significant financial challenges facing the service, the trust recognised that cost information had to improve to identify where savings were possible and develop clinical engagement. The detailed information offered by PLC was seen as an opportunity to understand casemix and cost variation.
The quality of information has improved. Increasingly, clinical and managerial budget-holders are using the system’s output to understand the effect of changing activity and its impact on use of resources. Costs can be analysed in a number of different ways – as well as at patient level, they can be examined by referring GP, consultant, age and healthcare resource group.
The health board’s head of corporate financial management, Nicola Prygodzicz, paid tribute to her colleague, finance manager (service development and improvement)
Hywel Jones, who was pivotal in the project’s development and implementation, but could not be at the ceremony to pick up the award.
She added: ‘It is really nice to get some credit for all the hard work, time and effort put in over the past three years. The system gives us a level of intelligence on costs, which we can use to set a foundation to cost patients across the whole spectrum of care – from general practice through to specialist services. We hope it will enable us to be the first organisation that will be able to cost patients from primary through to tertiary care.’
Cardiff and Vale believes the greatest improvement has been in the electronic capture and timely analysis of information about high-cost prostheses, which has allowed clinicians to review products used.
The costing team is planning a number of developments, including the integration of its mental health and community system with its data warehouse. Over the next 12 to 18 months it aims to have this information in its PLC system, giving it access to community and acute data on one system. It also plans to review costs per patient based on the day of the week on which they were admitted. This will improve pathway and patient flow to maximise use of resources.
The judges said ‘the genuine passion of purpose came through from all of the candidates’, which made it tough to choose a winner. But they were impressed with Cardiff and Vale’s system and by the thorough way in which its costing department had built its costing model. The team’s use of costing standards was praised, particularly references to MAQ (materiality and quality) scoring.
‘They offered confident and pragmatic solutions to many of the challenges of implementation in organisations of significant scale. This gave us the belief that they had experience to share that would be of value across the wider NHS, not just in Wales.’ the judges added.

The Judges

Tony Whitfield, Deputy Chief Executive & Director of Finance, Salford Royal NHS FT and Vice President, HFMA

Anja Kern, Research Associate, Healthcare Management Group, Imperial College London

Sarah Butler, Deputy Director – NHS Finance, PbR Operations, Department of Health

Helen Strain, Senior Finance Manager, University Hospitals Coventry & Warwickshire NHS Trust and HFMA Costing Lead

Ros Franké, Director of Finance & Deputy Chief Executive, Cheshire & Wirral Partnership NHS FT