Reference cost data published

The latest reference costs cover £66.1bn of NHS expenditure by 234 English provider trusts – an increase of nearly £2bn compared with the 2015/16 collection. This represents 62% of total NHS revenue spending. It includes £26.9bn spent on core admitted patient care, £10.7bn spent on outpatient attendances or procedures, mental health costs of £7.1bn, community costs of £5.6bn and ambulance costs of £1.9bn.

The average unit cost of a day case was £738, while inpatient episodes cost on average £3,684 (elective) and £1,590 (non-elective). Both figures exclude excess bed days beyond the trim points of different healthcare resource groups. Each excess bed day cost an average £313, while an outpatient appointment cost £120 and an A&E attendance cost £148.

A reference costs index provides a measure of relative cost difference between NHS providers, with an index of 100 indicating national average costs. The full range for 2016/17 extends from 72 to 133, although this is distorted by mental health and community providers, where lack of data means costing is less well developed. The range for acute trusts is much tighter.

A schedule of costs also provides the average costs and interquartile range for different procedures and treatments.

Currently providers are required to submit reference costs. But acute providers are already submitting acute patient-level costs on a voluntary basis as part of NHS Improvement’s Costing Transformation Programme. Collections will run in parallel next year and, if they reconcile successfully, there will be a single cost collection for acute services based on patient costs from 2019.