Case study / Using PLICS to drive service improvement- Nottingham’s Wave programme

Providers of NHS services have increasingly large amounts of data about the treatments and services provided to their patients following the roll-out of patient-level costing (PLICS) across the NHS. Their challenge is how to make the most of this wealth of data to deliver efficiencies and support improvements in patient care.

Nottingham University Hospitals NHS Trust (NUH) has successfully integrated PLICS into their Wave programme, using PLICS to identify and investigate variation and then to model and monitor changes made to the way patient care is provided. 

This pioneering program aims to reduce waste and improve the quality of services provided. Through the Wave program, NUH has been able to secure greater levels of clinical engagement and commitment to its service improvement work.

This case study focuses on one specialty, spinal surgery. Through the Wave programme, the service identified many areas where improvements could be made to the way patient care is delivered. These changes have improved many of the service’s key performance indicators as well as the financial bottom line. In 2019/20 the service made a loss of £6.6m and had been making significant losses for many years. The service was unclear as to where to focus resources to improve the financial position. On completion of the Wave cycle, the service had developed a plan to improve their financial performance by between £1.5m and £2.2m. This has allowed the service to take control of their improvement journey and view their plans positively, as well as creating and owning a sustainable plan to move forwards.