Technical issues impact on costing submissions

Last week and at the beginning of this week, NHS England and NHS Improvement, together with NHS Digital, which handles the technology side of the collection, issued a number of joint statements alerting costing practitioners to ongoing problems.

There have been three issues. First there have been outages of the strategic data collection service (SDCS) – the online platform used to upload the National Cost Collection workbook – which have affected some trusts on some days. There have also been problems with the provision of summary reports for trusts submitting mental health care contacts (MHCC) files. This is now resolved.

And there has been a third problem affecting a proportion of files being validated – a ‘pending files’ issue. To counter this, trusts have been asked to submit as early as possible on their booked submission date.

‘We appreciate that this is frustrating for you and for all the organisations affected and apologise for the inconvenience caused,’ said the statement, which was signed by Helen Laing, NHS England and NHS Improvement deputy director of costing, and Richard Steele, NHS Digital programme head.

The upload of PLICS data is a massive undertaking, with costs for treating individual patients broken down into both resources consumed and the activities employed. In 2019/20, just for acute services, 137 providers reported a total cost of £44bn, relating to 18 million accident and emergency attendances, 17.8 million admitted patient care episodes and 76.8 million outpatient appointments.

The submission window for 2020/21 costs opened in September and runs through October and marks an increase in the amount of data flowing. This year, all providers subject to mandatory PLICS collections are submitting during the same window, while last year ambulance, mental health and IAPT services (improving access to psychological therapies) used a separate submission window.

Trusts have to provide 12 monthly files for each feed type, such as admitted patient care, emergency care, specialised ward care, outpatients, supplementary information, mental health provider spells and mental health care contacts. Additionally, they also submit a reconciliation file.

Practitioners spoken to by Healthcare Finance agreed that the submission problems were frustrating and would ideally have been found by testing. However, they were more concerned about whether the problems related to the sheer volume of data being submitted and whether there could be a knock-on impact in terms of delayed processing. The 2019/20 cost data was only released in June this year and then had to be republished after errors were found in the initial version.

NHS Digital’s John Winter told Healthcare Finance that the volume of data being submitted was not a factor in the system outages or with the mental health reporting issue. Investigations on the pending files issue were still being undertaken.

Mrs Laing said it was ‘too early to say’ if there would be any further impacts from the submission problems. But she said that the costing team and NHS Digital were meeting regularly and the team would continue to keep costing practitioners informed.

NHS England and NHS Improvement are currently exploring options for more frequent collection of cost data. However, there are still concerns that the methodology is too complex and that data is collected in a format that differs too much from that used locally by trusts. (See the HFMA Healthcare Costing for Value Institute’s What does good look like for costing in the NHS?).