Patient Level Activity and Costing, 2021-22

A total cost of £4.1 billion over 16.4 million attendances was reported for MHCC, which includes patients receiving non-admitted mental healthcare. This is summarised by the cluster code assigned to each patient, indicating the mental health diagnosis they are receiving treatment for, as part of the PLICS data collection. £2.2 billion (53.4%) of the total cost of MHCC activity related to patients that were not accepted into the Mental Health service, not assigned to a cluster, or not assessed.

In addition, 4.3% of total cost related to patients assigned to cluster ‘Variance (unable to assign Adult Mental Health Care Cluster Code)’ and less than 0.1% was associated with ‘Cluster under review’. The attendance counts and total costs associated with all other care clusters are displayed in the chart below.

A total cost of £3.1 billion was reported for MHPS activity. This is summarised by the cluster code assigned to each patient, indicating the mental health diagnosis they are receiving treatment for, as part of the PLICS data collection. £1.1 billion (35.7%) of the total cost of MHPS activity related to patients that were not accepted into the Mental Health service, not assigned to a cluster or not assessed.

In addition, 4.1% of total cost related to patients assigned to cluster ‘Variance (unable to assign Adult Mental Health Care Cluster Code)’, less than 0.1% was associated with ‘Cluster under review’ and less than 0.1% was associated with a missing care cluster code. The total cost associated with all other care clusters are displayed in the chart below.

Care cluster code is a required field for the PLICS 2021-22 MHCC and MHPS submissions, this means it may not be recorded as part of a provider’s submission.

MHPS activity counts are not reported as recording of activity may not be consistent across providers.

IAPT data can provide mental health related cost and activity breakdowns similar to the MH datasets using cluster codes assigned to each patient as part of the PLICS data collection. There were £596.8 million recorded costs across 4.7 million appointments, of which £389.1 million (65.2%) were assigned a care cluster and £207.7 million (34.8%) related to patients that were not accepted into the Mental Health service, not assigned to a cluster or not assessed.

In addition, 5.9% of total cost related to patients assigned to cluster ‘Variance (unable to assign Adult Mental Health Care Cluster Code)’ and less than 0.1% was associated with ‘Cluster under review’. The appointment counts and total costs associated with all other care clusters are displayed in the chart below.

The category presented in the chart above as ‘Other Care Cluster’ covers several values. Breakdowns of activity and cost submitted in these categories is available in the accompanying csv data file supplied with this report. 

Care cluster code is a required field for the PLICS 2021-22 IAPT submission meaning it may not be recorded as part of a provider’s submission.

CSCC includes costs relating to care activities undertaken by providers of community service care contacts. There were £4.2 billion recorded costs associated with 57.5 million care activities.

From the submitted PLICS consultation type, 70.2% of care activities (68.7% of cost) had a consultation type of Follow-up Consultation, 18.0% were classified as Initial Consultation (20.0% of cost) and 11.8% were Unknown (11.3% of cost).

From the submitted PLICS consultation medium, the largest grouping was Face to face communication which contained 69.8% of care activities (70.4% of cost).

The category presented in the chart above as ‘Other consultation medium’ covers several values for consultation medium submitted including: ‘Telemedicine’, ‘Email’, ‘Short Message Service (SMS) - Text Messaging’, ‘Talk type for a person unable to speak’ and ‘Other’.

Breakdowns of activity and cost submitted in these categories is available in the accompanying csv data file supplied with this report.  

From the submitted PLICS service or team type, the largest grouping was District Nursing Service which contained 45.9% of care activities (33.1% of cost).

The category presented in the chart above as ‘Other Service or Team Type’ covers several values. Breakdowns of activity and cost submitted in these categories is available in the accompanying csv data file supplied with this report.

The Patient Level Information and Costing System (PLICS) Ambulance data collection includes mandatory and required data items.

For a PLICS Ambulance data submission to be accepted, all mandatory data items must be completed with valid values.  Mandatory data items are therefore 100% complete for all providers, although other data quality issues may be found when analysing such data.

Required data items may be left blank in a submission, either because the provider does not hold the relevant data in their information systems, or the data item does not apply to an incident.  Completeness of each required data item may vary significantly between submitting providers.

This analysis of PLICS Ambulance data reports on:

• Incident outcome - a mandatory data item
• Response type - a mandatory data item
• Number of response units arriving at a healthcare provider – a required data item which had high data completeness for all providers

For each of these breakdowns, variation between providers should be interpreted with caution as it may reflect differences in how data has been extracted from local systems for submission to the PLICS Ambulance collection rather than true variation in services provided.

The response type or types arriving on scene are reported for each ambulance See and Treat incident.

The response type reported was not consistent with other submitted information about the incident for 16.2% of See and Treat incidents and 18.0% of total See and Treat costs.  (For example, more or fewer response types were listed than the reported total number of response units arriving on scene.)

In this table response units such as motorbikes and hazardous area response team vehicles are grouped together as ‘Other specified response type’.  Activity counts and total costs for each response type are included in the csv file published alongside this report.

The number of response units arriving at a healthcare provider is reported for each See and Convey incident.

The number of response units was missing or zero (which is not consistent with a See and Convey incident) for 4.4% of See and Convey incidents and 3.2% of total See and Convey costs.

Where the number of response units was submitted and was consistent with a See and Convey incident, 74.6% of the total reported cost related to incidents for which a single response unit arrived at a healthcare provider: