News / Cost gap remains steady

The costs, published by the Department of Health at the end of November, cover £58.3bn of NHS expenditure – an increase of £3.2bn compared with costs in the 2012/13 collection and representing 55%
of total NHS spending in 2013/14.

With a reference cost index of 100 representing national average costs, the range for acute trusts stretched from 114 to 83. This range of 31 percentage points compares with a range of 30 percentage points in 2012/13.

Stripping out trusts with known data problems in 2012/13, the full range across all providers was also similar over the two years (78 in 2013/14 and 74 in 2012/13). More than half of all trusts (125) were within five percentage points of an RCI of 100.

Reference cost schedules were also published showing the national average costs of treatments and procedures (in healthcare resource groups). The data suggests there were cost increases in all three of the highest volume elective HRGs. For example, the national average cost of HRG HB21C (major knee procedures for non-trauma, category 2, without comorbidities or complications) rose by 0.5% compared with a general tariff price reduction of 1.3% for the year.

Monitor has also published a roadmap setting out plans to move to patient-level costing – although it said reference costs would remain important in the transition period.