Technical review - summer 2020

A total of 27 acute providers have been asked to submit costs for the first quarter of 2020/21 to help improve understanding about the impact of Covid-19 on the costs of patient care. NHS England and NHS Improvement announced the exceptional quarterly collection (EQC) in August and, if it proves successful, the organisations plan to collect costs for the remaining quarters at later dates. The data will be used to analyse the extent of the change in cost profile caused by the pandemic – both on Covid and non-Covid patients. Any trusts taking part may be able to move their National Cost Collection submission date if required. Where possible, the EQC template will be pre-populated with data for trusts to verify and the basis of submissions does not need to be Costing Transformation Programme-compliant. Trusts will submit aggregate data – not patient-level cost data – for A&E, admitted and non-admitted care, rehabilitation and critical care, profiled by fixed, semi-fixed and variable. Any other trusts keen to get involved in this collection are asked to contact: [email protected] 

The HFMA Healthcare Costing for Value Institute has published an updated version of the Introductory guide to costing in the NHS. The guide, which is available for download by institute members, describes the fundamental elements of the costing role and highlights sources of further support and information. It provides an overview of the importance of costing, as well as the key steps involved in driving patient-level cost data. In addition, the guide sets out a typical patient-level costing cycle for costing practitioners. 

Guidance on the use of agency staff during Covid-19 was updated at the beginning of August. It includes a suggested interpretation of PPN (procurement policy notice) 02/20 – and the provisions of PPN 04/20 – regarding the payment of ‘at risk’ providers. It sets out the circumstances where bank or agency workers affected by Covid-19 should receive full or partial pay. The guidance also emphasises the need for agency spending to remain on-framework, with alleged profiteering reported to NHS England and NHS Improvement.


A new version of Who pays? has been released by NHS England. The document, which was last published back in 2013, sets out the framework for establishing which NHS commissioner is responsible for commissioning and paying for an individual’s care. The new document pulls together previous separate addenda and explanatory notes into a single source. It also takes account of the discharge to assess arrangements set out in Hospital discharge service: policy and operating model, which was published in August. And it sets out a mandatory dispute resolution process.