Patient Level Activity and Costing, 2021-22

This analysis uses the Patient Level Information and Costing System (PLICS) data for 2021-22 collected between 18 July and 2 September 2022 by NHS Digital.  This data was collected in compliance with a Mandatory Request from NHS England, and in accordance with the Information Standard.

The mandatory request lists the NHS providers identified by NHS England as required to submit PLICS data for 2021-22.

The PLICS collection for 2021-22 included:

Acute services:

• Emergency care (EC) attendances
• Admitted patient care (APC) episodes including community inpatient episodes
• Outpatient (OP) appointments and procedures
• Specialised ward care (SWC) - Adult, Paediatric and Neonatal critical care
• Supplementary Information (SI) - high-cost drugs, high-cost devices, and unbundled outpatient diagnostic imaging.  To note, SI services are included from both Acute and MH providers

MH services:

• Complete and incomplete hospital provider spells
• Care contacts for non-admitted patients

IAPT services:

• Each provider generated a PLICS IAPT data extract using the costing data held on their local PLICS system

CSCC services:

• Community health services care contacts

Ambulance services:

• All incidents going through 999 call centres or dispatch centres
• Each provider generated a PLICS Ambulance data extract using the costing data held on their local PLICS system
• For each incident, the data submitted included an activity record and costs relating to that activity, split by a specified list of collection activities (such as dispatch and control or patient handover) and collection resources (such as drugs and consumables or fleet resources)

Full details of the services in and out of scope are available in the National Cost Collection guidance published by NHS England.

For each activity (such as an episode, care contact or appointment), the data submitted included an activity record (with identifiers to permit linkage to other data sets) and costs relating to that activity, split by a specified list of collection activities (such as ward care, outpatient care, pharmacy, or group session) and collection resources (such as doctors or nurses).

Submitted PLICS data includes some instances of negative costs at a cost record level and at the activity level. Negative costs are not excluded from the calculation of aggregated costs in this report and in the csv output. This means that there are three values within the ‘Sex and Age Group’ breakdown in the csv output where the calculated aggregated cost is negative at a sub-national level. This is consistent with inclusion decisions taken in the NCC publication and reporting.

For hospital provider spells, APC episodes and adult, paediatric and neonatal critical care periods that spanned the start or end of the period (started in a prior financial year, or had not ended by 31 March 2022), costs relating to the bed days that fell within the financial year were included.

For MH, learning disabilities services were included.  Children and adolescent mental health services (CAMHS), drug and alcohol services, mental health specialist teams, secure mental health services and specialist mental health services were not included.

Providers used a tool published by NHS England to convert their data extract into files in the required format for submission, before uploading their PLICS submissions to a secure NHS Digital portal.  Resubmissions could be made, and the most recent submission for each provider was retained.

The NHS England conversion tool required all data items to be in the correct format and all mandatory fields to be populated to generate the files for submission.  The tool also generated warnings for potentially incorrect data such as negative cost episodes for providers to review and improve data quality.

NHS England reviewed summary data from the PLICS collection during the collection window. Details of trusts excluded from both the NCC and this reporting are detailed in the Coverage – providers section.
 

The latest submission from each provider was retained.

The Acute EC, APC and OP data from the set of submissions has been linked to Hospital Episode Statistics (HES) data for 2021-22 (the Linkage to Hospital Episode Statistics section provides further details).

The MHPS and MHCC data from the set of submissions has been linked to the Mental Health Services Data Set (MHSDS) data for 2021-22 (the Mental Health section of Data completeness – linkage provides further details).

The IAPT data from the set of submissions has been linked to the separate IAPT data collection for 2021-22 (the IAPT section of Data completeness – linkage provides further details).

The CSCC data from the set of submissions has been linked to the Community Services Data Set for 2021-22 (the CSCC section of Data completeness – linkage provides further details).

Following data quality checks by NHS England, some data has been excluded as stated in the Data Quality - Coverage section.

The PLICS data for 2021-22 was pseudonymised and released to NHS England.  This data will be used in the National Cost Collection outputs, the PLICS Portal for submitting NHS providers, and other tools and analysis.