Clinical Training Tool (CTT) HRG4+ 2019/20

Download the Clinical Training Tool HRG4+ 2019/20 application

The Clinical Training Tool (CTT) has been developed by the National Casemix Office (NCO) in partnership with our 3rd Party Software Supplier, Woodward Associates, with the primary aim of enabling end users to understand the Casemix HRG4+ design. Initially developed for use by the NCO’s Casemix Consultants to work more effectively with our Clinical Expert Working Groups, Service-led demand has resulted in the release of this product to the wider NHS.

The CTT promotes the transparency of our design, and will allow users to conduct ‘what-if’ modelling, and understand the impact of numerous clinical and administrative variables on the HRG design, including:

• Coding sequencing, depth and accuracy
• Patient age
• Length of stay

This version of the CTT is based on the HRG4+ 2019/20 Local Payment HRG design and encompasses single spell and viewer functionality as used in our standalone Grouper products.

In order to understand how the national system fits together, from design via commissioning to reimbursement, the CTT includes an integrated Prescribed Services (PS) algorithm (the PSO 2019/20) and the 2019/20 NHSE/I mandatory tariffs and business rules, as applicable. The national tariffs for 2019/20 are included in order to provide a consistent measure of resource associated with each HRG, dependent on care setting and underlying data quality.

The inclusion of the 2019/20 Operational PS Algorithm provides an indication of how national and local commissioning rules can be affected by data quality. As a result of integration, diagnosis codes are included in outpatients, but while used for PS service line generation, they are not used in the HRG generation and as such are not mandatory for inclusion.

The CTT does not replace the existing standalone NCO Products for 2019/20 but serves to facilitate local clinical dialogue in understanding the Casemix design, and to illustrate the ramifications that poor data quality can have on both income and the identification of National Specialised Services.

The CTT should be used to educate and inform, and ultimately to improve data quality at both the local and national level, enabling more informed decision-making to be made at all levels, in support of improved patient care and outcomes.

It is hoped that in the future the NCO will be able to update the CTT for use in the 2020/21 financial year, incorporating the HRG4+ 2020/21 Local Payment HRG design and associated reimbursement and specialised services algorithm.

Any questions, comments, observations or recommendations for enhancement of the CTT should be sent to [email protected]

Clinical Training Tool User Manual - this document provides full instructions on how to install and use the application, as well as providing a brief introduction to the purpose and uses of the Clinical Training Tool.

Clinical Training Tool Demo Data HRG4+ LP2019/20 - an Excel file containing two tabs has been created to let users familiarise themselves with using the CTT.  The file contains data relating to Admitted Patient Care (APC)  and Outpatients (OP)  and rows of data can be directly pasted into the Single Spell. Examples are given for each of the HRGs in the 2019/20 design that can be generated in APC or OP to demonstrate the elements of the design that are important in the generation of the HRG. Please note these are examples, which therefore may not adhere to national coding standards and are not representative of real patient records. The data can similarly be saved as CSV files and loaded directly into the Viewer and from there, each record can be transposed into Single Spell easily.