Views sought on National Cost Collection for 2020/21

Last year’s NCC, covering the 2019/20 financial year, was delayed as part of the response to Covid-19, with some costing practitioners redeployed during the first wave to support frontline services and most finance teams switching to working from home. Instead of summer submissions, acute and community providers submitted in autumn 2020, while mental health and ambulance submissions are submitting this month.

A newsletter from the central bodies to costing practitioners this week said all the planned timescales and activities for 2021 were now being reviewed in the light of the current pressures on the NHS due to a second wave of the virus. It said that while current pressures were not unexpected, they did appear to be more challenging than previously planned for.

A survey has been sent to NHS providers with feedback used to inform the ‘best way to proceed with the costing transformation programme’. ‘We want to ensure we appreciate fully all the challenges you are facing before having further discussions about the implementation of the programme,’ the newsletter said.

Providers are asked to give their view of the likely impact of Covid-19 on the quality of costs that would be submitted. There are concerns about the accuracy of costs and their usefulness given the major changes to funding and service delivery arrangements during 2020/21.

However, the two bodies appear to be working on the basis of a collection going ahead, while making it easier for costing practitioners to meet the submission requirements.

The survey acknowledges that ‘the ability to comply with all costing standards and the level of accuracy within data systems will be reduced for the financial year 2020/21’. It states that the national bodies are planning to adjust the costing assurance programme to take account of this and asks if this adjustment will make the submission easier.

It also asks if organisations would support a delay in the collection from early summer to September – or what their preferred submission timetable would be. While allowing more time for the collection may ease pressures, some organisations are known to prefer retaining the original submission timetable, so that the collection does not interfere with local costing and improvement work.

The survey also looks to gather intelligence on whether costing practitioners have been redeployed again as part of their organisations’ responses to the second wave.

Covid-19 has demanded a significant amount of the service’s focus and has had an impact on many other work programmes including the costing transformation programme. However, it is understood that NHS England and NHS Improvement are keen to retain momentum with the programme. It is currently consulting on proposals to mandate community service providers to collect and report patient-level costs from 2021/22.

And at December’s HFMA annual conference, NHS England and NHS Improvement chief financial officer Julian Kelly (pictured) raised the idea of increasing the frequency of patient-level cost collections. He pointed to the fact that while the NHS had a lot of costing data, by the time it was processed it was 18 months old.

‘We ran an emergency cost collection in the second or third quarter as we were trying to get our heads around the impact of Covid,’ he said. ‘Can we not do some sort of quarterly cost collection? The data would be useful for local, system, regional, and national organisations, commissioners and providers to see where the productivity opportunities lie. It’s about getting a balance between good costing data and timeliness.’

As part of the consultation on mandating patient-level costing for community services, NHS England and NHS Improvement have asked for views on the potential move to quarterly reporting.

However, the HFMA has previously raised concerns about the current costing standards that NHS providers are required to follow in producing patient-level costs – suggesting they are not proportionate to the benefits they provide. Providers are required to collect costs in far greater detail than the level required for central submission, leaving little time to support local improvement work, and use costs in a different format to inform local management.