Ambulance PLICS cost collection guidance 2017/18

Transcription

1 Ambulance PLICS cost collection guidance 2017/18 August 2018

2 We support providers to give patients safe, high quality, compassionate care within local health systems that are financially sustainable.

3 Contents 1. Introduction Background Collection timetable Scope of collection Information governance Applying the Healthcare costing standards for England Collection resources and activities Data specification Treatment of specific scenarios and costs: additional guidance Reconciliation tables Data validation and submission Contact details > Introduction

4 1. Introduction This guidance gives the technical costing specifications we are asking ambulance services to follow for the collection of 2017/18 patient-level information and costing systems (PLICS) data in November The collection is for providers who have volunteered to be early implementers of the Healthcare costing standards for England, 1 before the proposed first mandatory implementation of the standards and data submission for 2019/20. This year the collection will be run by NHS Digital. NHS Digital is experienced in specifying, acquiring and processing national data collections. This document includes details on the information governance of the collection (Section 5). We advise providers to make sure the information governance lead in their organisation is aware of this, and to support any relevant approval needed to participate in the collection. We will work closely with early implementer ambulance services leading up to the collection to ensure they are ready to submit data and to understand any issues that arise. This will enable us to improve the collection in future years. This years ambulance PLICS process is voluntary and all ambulance services need to continue to submit reference costs in 2018 as part of the national cost collection > Introduction

5 2. Background The costing transformation programme (CTP) is focused on achieving a step change in the quality of cost information and a single national cost collection through the rollout of patient-level costing. Each sector is undertaking this transition, in line with the timetable shown in Table 1 below. The single national cost collection will closely align with providers local costing methods, minimising the work required to complete the national cost collection and providing a consistent costing methodology for the service. We expect the cost collection, coupled with implementing the Healthcare costing standards for England, to: improve the quality and consistency of cost information available to the service ensure organisations can understand their costs enable organisations to benchmark costs with and across providers. Table 1: Costing transformation programme timetable In 2017, three ambulance services submitted costs to a pilot collection; 2018 is the first of two further voluntary collection processes. We encourage all ambulance services to participate before a collection in 2020, which subject to consultation we intend will be the first mandatory collection of PLICS data from the ambulance sector. 3 > Background

6 3. Collection timetable Table 2 below outlines the timetable for the ambulance PLICS collection for Table 2: Timetable for PLICS (CTP) cost collection Date Early October Late October 5 th November 16 th November Early 2019 Description Data validation tool update released Test of systems/collection readiness confirmation Collection window (TBC) Collection feedback and lessons learned shared 4 > Collection timetable

7 4. Scope of collection Providers are asked to submit activity and financial data for all incidents going through 999 call centres or dispatch centres. The definition of an incident for the purposes of this collection is a discrete event where one or more response units are dispatched or clinical advice is given over the phone. This includes these services: activity completed by third party providers hazardous area response teams (HART) medical emergency response incident teams (MERIT) healthcare professional responses air ambulance responses (staff only). The following services are out of scope of the collection: other patient-facing services, eg GP out-of-hours, patient transport service (PTS) and 111. Other operating income relating to commercial services (eg first aid training, sporting events, etc) is to be netted off as an estimate of cost as part of the reconciliation process to establish the total amount of provider costs. This is a change from the roadmap partner collection last year to align the reconciliation part of the PLICS collection with reference costs Collection year The collection year is 1 April 2017 to 31 March All jobs where the incident date and time is within the collection year are in scope of this collection. 5 > Scope of collection

8 5. Information governance This section details the information governance of the data collected from early implementer trusts this year. The collection run by NHS Digital is subject to a mandatory request 3 from NHS Improvement being accepted by NHS Digital. The request will be for NHS Digital to establish and operate a system to collect patient-level costing information under Section 255 and 256(2)(a) of the Health and Social Care Act On acceptance of the mandatory request, NHS Digital will issue a Data Provision Notice (DPN) 4. The expectation is that NHS Digital may disseminate data collected and/or created under that request. This will include dissemination to NHS Improvement, and potentially may include dissemination to other organisations. The acceptance of the mandatory request and any subsequent use of the data collected would be subject to information governance processes and approval. NHS Digital will collect ambulance PLICS data (PLCAMDS) from Ambulance providers and pseudonymise the data, before the resultant data (Pseudo-PLCAMDS) is provided to NHS Improvement How we will use the collection data We intend to use the 2017/18 cost data collected from early implementer providers to: inform ambulance costing standards development inform developments to the CTP PLICS collection, including the impact assessment on mandating the submission of PLICS inform the development of benchmarking metrics and to develop and populate a benchmarking tool inform development of the Carter review programme s Model Ambulance and populate this where applicable informing and modelling new methods of pricing NHS services informing new approaches or changes to currency design > Information governance

9 In the event of the intended use of PLICS data being updated for the collection in future years, the data collected this year will remain covered by the information set out in the Mandatory request, the DPN and in this document. We will not use or share the data for any purpose other than those listed above Sharing of data NHS Improvement may use the collected PLICS data for the purposes described above. As well as sharing Pseudo-PLCAMDS data within NHS Improvement, we may also (subject to NHS Digital s approval) share Pseudo-PLCAMDS data with NHS England or Health Education England for these purposes. In developing and populating a PLICS benchmarking solution, NHS Improvement may also share suitably aggregated Pseudo-PLCAMDS (determined in consultation with participating organisations) with other trusts taking part in this collection. Any sharing of PLICS data by NHS Improvement (excluding back to the trust that owns the data) will be subject to a data-sharing arrangement approved by the Information Asset Owner of Ambulance PLICS at NHS Improvement and subject to NHS Digital s approval Freedom of Information requests All public-sector bodies are bound by the requirements of the Freedom of Information Act 2000 (FOIA) and anyone can submit an FOI request. In line with NHS Digital or NHS Improvement s FOIA process and within the statutory timeframes set out under the FOIA, either organisation may engage with third party organisations in relation to a given FOI request. Contact with relevant third parties around an FOI request received by either organisation will be on a case by case basis and dependent on the nature of the request. As such, under relevant circumstances and depending on the nature of the FOI request, NHS Digital or NHS Improvement would contact the trust(s) concerned. NHS Digital may also contact NHS Improvement in respect of an FOI request (where appropriate). 7 > Information governance

10 5.4. Data retention NHS Digital will also store PLICS data as part of this collection in line with NHS Digital s retention policy. NHS Improvement will keep the data for seven years. After this time the data will be securely disposed of by NHS Improvement s IT team. 8 > Information governance

11 6. Applying the Healthcare costing standards for England The cost collection should be completed in line with the Healthcare costing standards for England: Ambulance (second version). 5 This specifies how you should map costs to resources and activities, and the allocation methods to use. Lists of costing resources and activities are included in spreadsheets CP3.1 and CP3.2 of the technical document for the costing standards. Due to the nature of ambulance service provision, the cost collection is at the incident level, with the number of vehicles arriving at a treatment location used as a proxy for the number of patients associated with each incident. If no vehicles arrive at a treatment location the incident is assumed to be a single-patient incident > Applying the Healthcare costing standards for England

12 7. Collection resources and activities This section describes the resources and activities you should use to report costs for this collection. Spreadsheets CP3.1 and CP3.2 in the costing standards technical document 6 contain a list of the allocation resources and activities and how they map to those for collection. These collection resources and activities are set out in Table 3 and Table 4 below. Table 3: Cost collection resources Collection resources Drugs and consumables resources Emergency operations centre resources Equipment resources Fleet fuel resources Fleet resources Frontline staff resources Hospital ambulance liaison officers (HALOs) Support costs Third-party frontline resources Table 4: Cost collection activities Collection activities Call handling and telephone clinical advice Dispatch and control Allocation to mobile Mobile to scene Time on scene Convey patient to treatment location Patient handover Handover to clear Non-responding time CNST indemnity > Collection resources and activities

13 8. Data specification 8.1. Extract specification The extract file specification is published alongside this collection guidance, setting out the exact structure of the CSV files to be produced for the collection. This provides field names and formats, along with valid codes for certain fields where applicable. The extract may also be produced in an XML format and we will provide a similar specification for this. The extracted files must be passed through the NHS Improvement data validation tool prior to submission to NHS Digital (see section 11) File batching process of incident data The data extract should be split into 12 monthly files using the incident date and time field. Incidents must only be reported in the month of the incident date to prevent duplication. Monthly file batching is important to ensure the file transfer process can upload the large data files produced by the new costing method Extract file name convention File names must comply with the following naming convention: FeedType_FinYr_FinMth_OrgSubmittingID_CreateDateTime.csv FeedType_FinYr_FinMth_OrgSubmittingID_CreateDateTime.xml This will also be set out in the extract specification document. Table 5 details the component parts of the file name. If file names do not follow this convention the submission will be rejected. 11 > Data specification

14 Table 5: File name convention Field Name Name Description Patient-level costing care activity type code FeedType The dataset the extract covers. AMB = Ambulance Financial year FinYr The financial year the extract covers: ie for 2017/18 the value would be FY Financial month FinMth The month the extract covers within the financial year: ORGANISATION identifier (code of submitting organisation) M01 = Apr 2017 M02 = May M03 = Jun M04 = Jul M05 = Aug M06 = Sep M07 = Oct M08 = Nov M09 = Dec M10 = Jan M11 = Feb M12 = Mar 2018 OrgSubmittingID ORGANISATION IDENTIFIER (CODE OF SUBMITTING ORGANISATION) is the ORGANISATION IDENTIFIER of the organisation acting as the physical sender of a dataset submission. Date and time dataset created CreateDateTime The organisation code provided must be in the 3-character format (XXX) and is the main code of the provider The date and time the extract was created. Format to be used: CCYYMMDDThhmm Examples of correct filenames are as follows, where XXX represents the organisation identifier (code of submitting organisation): AMB_FY _M01_XXX_ T1730.csv AMB_FY _M01_XXX_ T1730.xml 8.4. Data fields The data to be submitted is at an incident level, with some information included on response(s) and patient(s). The field list to be collected for each incident is shown in Table > Data specification

15 A more detailed description of each field is included in Sheet IR1.2 of the ambulance technical document and in the file extract specification. The fields for NHS number, Responder type and Organisation code (handover destination) can contain multiple entries if required, delimited with a vertical bar character. Multiple entries in these fields can be in any order. Therefore details of all responders that arrive on scene to an incident should be submitted. Table 6: Activity fields Data field name CSV field name Mandatory field Organisation identifier (code of provider) OrgId Y Organisation identifier (code of OrgCom N commissioner) Incident ID IncID Y Source of call CllSrce N Call category CllCat N Multi-patient incident MltPat N Number of response units mobilised for UntsMob N incident Number of response units arriving on scene UntsSc N Number of response units arriving at UntsHsp N treatment centre Incident date and time IncDateTime Y Job cycle duration (seconds) JobDur N Incident currency IncCcy Y NHS number NHSNoAmb N Responder type RTyp N Organisation identifier (handover destination) OrgHdvr N Table 7 shows the costing fields to be collected for each incident. For each incident, there should be a separate line of data for each Collection activity/collection resource combination, as well as the cost for this combination. Therefore each incident will consist of a number of lines of data in the extract files. 13 > Data specification

16 Table 7: Costing fields Data field name CSV field name Description Collection activity ID ActCstID Unique identifier to report costing activity Mandatory field Y Collection activity count ActCnt Activity count for each activity Y Collection resource ID ResCstID Unique identifier to report resource groups Y Total cost TotCst The financial value of the resources consumed by the activities carried out Y The collection activity count set out in Table 7 is associated with each collection activity for each incident. It should be the same for that collection activity regardless of how many collection resources it is combined with. Table 8 gives an illustrative example of this for a single incident. Table 8: Illustrative example of collection activity count Collection activity ID Collection activity count Collection resource ID Total cost A 50 w 8.98 A 50 x A 50 y A 50 z 0.54 B 458 w B 458 x B 458 y B 458 z > Data specification

17 9. Treatment of specific scenarios and costs: additional guidance 9.1. Assignment of incident currency One of the fields to be collected is incident currency. This is to be based on the four national reference costs categories: Calls Hear and treat or refer See and treat or refer See and treat and convey. In line with the ambulance costing standards, 7 the cost of calls should be absorbed into the cost of the associated incident. For calls that do not result in an incident, the cost should be absorbed across other activity. The category Calls should therefore not be assigned to any incident in this collection. Spreadsheet CM1.1 of the ambulance technical document contains various ambulance activity scenarios. We recognise that not all scenarios fit into one of the national reference costs categories. For the purposes of the PLICS collection only, these categories should therefore be used: Hear and treat or refer See and treat or refer See and treat and convey Other scenario. The Other scenario should be assigned where there are no patients (see scenarios 2.6, 2.7 and 3.1 on Spreadsheet CM1.1 of the ambulance technical document) > Treatment of specific scenarios and costs: additional guidance

18 9.2. Treatment of costs where there are no patients For scenarios where there are no patients (see scenarios 2.6, 2.7 and 3.1 on Spreadsheet CM1.1 of the ambulance technical document), a proxy incident ID should be created to allocate costs to. This should be submitted to the collection in the same way as any other incident Unmatched costs Scenario 2.5 in Spreadsheet CM1.1 describes responses that are stood down while mobile because duplicate call(s) have resulted in another response arriving on scene first. If possible, the cost of these stood-down responses should be allocated to the incident generated by the duplicate call that resulted in a response arriving on scene. If matching of duplicate call identifiers is not possible, the cost of the stood-down response should be absorbed across all other See and treat or refer and See and treat and convey incidents. 16 > Treatment of specific scenarios and costs: additional guidance

19 10. Reconciliation tables Reconciliation forms an important part of the submission files. The reconciliation file is closely aligned with the reconciliation statement used for reference costs in the national cost collection. 8 The reconciliation file should be generated directly from the costing system in a CSV or XML format. Details are included in the extract specification file for the CSV format and we will provide a similar specification for the XML format. The figures in the reconciliation file should be in pounds ( ) rather than thousands of pounds. The reconciliation will establish the total costs covered by the PLICS collection from your final audited accounts. There are two tables as part of the reconciliation: final audited accounts service and cost exclusions Final audited accounts The final audited accounts table (Table 9 below) reconciles the provider audited accounts to the total costs and is the same as that in reference costs. Please see Section 20 of the National cost collection guidance for information on how to populate each of the lines in this table. All of a provider s costs, as well as other operating income and gains, should be reported in the final audited accounts table. Contact NHS Improvement s cost collection team to discuss the treatment of rare items or if you are unsure how to report some costs: costing@improvement.nhs.uk > Reconciliation tables

20 Table 9: Final audited accounts reconciliation Out-of-scope services and costs The service and cost exclusions table (Table 10 below) combines the costs of the services out of scope of the PLICS collection to reconcile to the total costs collected. Out-of-scope services in the PLICS collection differ from those in the reference costs collection. 18 > Reconciliation tables

21 For this year s collection, the costs of out-of-scope services have been combined into one line. In future these may be split by service for additional transparency. Table 10: Service and cost exclusions 19 > Reconciliation tables

22 11. Data validation and submission Data validation tool Before submitting files, providers must pass them through our data validation tool. We will early implementer providers with details of how to access and use the data validation tool later in the year. Full details of the exact validation checks involved will also be published on our website. The data validation tool carries out several checks to make sure the files are in the correct format for submission, mandatory fields are populated and valid codes have been used in fields where applicable. An output file is produced from the tool setting out any discrepancies to the file specification that need to be amended before submission. If your software system produces extract files in CSV format, the data validation tool will also convert valid files to the XML format and compress them ready for submission. Conversion is not necessary for systems that produce extract files in the XML format, so valid files will just be compressed after checking. Given that this is the first year of a wide-scale collection of PLICS cost data from ambulance services, validation checks which would result in a submission failure are to be restricted to file structures, field formats, population of mandatory fields and ensuring that valid codes have been used where applicable. Blank fields will be accepted for non-mandatory fields. However, trusts should endeavour to complete as many fields as possible Submission of data files The reconciliation file and 12 monthly activity files are to be submitted to NHS Digital during the collection window. All files for transfer should be in the compressed XML format as output from the data validation tool. 20 > Data validation and submission

23 The submission will be made through NHS Digital s Secure Electronic File Transfer (SEFT) 9 service. We will contact participating providers before the collection window opens to provide guidance on how to use this service. 12. Contact details For any queries on the 2018 ambulance cost collection, please contact NHS Improvement s cost collection team at costing@improvement.nhs.uk > Contact details

24 Contact us: NHS Improvement Wellington House Waterloo Road London SE1 8UG This publication can be made available in a number of other formats on request. NHS Improvement 2018 Publication code: CG 59/18