News / Standards put NHS on path to better costing

New costing standards to underpin NHS Improvement’s accelerated Costing Transformation Programme were due to be released at the end of January.

Published after Healthcare Finance went to press, the oversight body’s new Approved costing guidance was set to include firm costing standards for acute trusts and draft standards for both mental health trusts and ambulance trusts.

Draft standards for acute trusts were initially
published last April. But Richard Ford (pictured), NHS Improvement’s costing director, said the standards had been through significant refinements as a result of detailed engagement with six acute ‘road map partners’ and feedback from costing practitioners in general over the last year. 

‘We are very proud of the standards and we couldn’t have done this without the support of costing practitioners,’ he said. ‘They’ve really helped us to stress test the approach.’

One of the key changes generally in the approach taken by NHS Improvement is to require costs to be mapped to different resource types and then allocated to different activities. The initial resource-activity matrix has now been rationalised to make both submission and collection of costs more manageable. 

In general, Mr Ford said, the standards had been made more flexible and pragmatic compared with the draft version. For example, some organisations can split pathology costs by individual tests and by pay and non-pay. In other trusts – where pathology is outsourced, perhaps –w trusts use simple weightings to allocate costs across tests. The standards now allow for both approaches.

A first group of ‘about 80’ acute early implementers will use the standards to make a patient-level cost submission in July. 

Mr Ford said the hope was then to take a second cohort through a submission in the second half of the year, by which time an announcement to mandate use of the standards from April 2018 is expected to have been made. The first mandatory collection for acute trusts will cover costs for the 2018/19 year, submitted in summer 2019. 

Draft mental health and ambulance service standards will now go through the same stress testing approach with sector-specific road map partners. 

Mr Ford said these represented the first patient-level costing standards for non-acute services across the world and that a number of countries were closely following progress. There is a recognition that both mental health providers and ambulance trusts are coming at the new process from a lower starting point, with fewer systems and data feeds in place.