Ambulance PLICS cost collection guidance 2017/18

Transcription

1 Ambulance PLICS cost collection guidance 2017/18 April 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 Provisional 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 autumn 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 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. This year the collection will be run either by NHS Digital or NHS Improvement; the outcome of this decision will affect the collection fields, the submission method and the date of the collection window. These differences are described in the relevant sections of this document. We will confirm to participating providers which organisation will be running the collection as soon as possible. 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 collection is voluntary and 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 collections. 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. Provisional collection timetable Table 2 below outlines the planned timetable for the ambulance PLICS collection for This timetable is subject to change based on whether NHS Digital or NHS Improvement runs the collection. Table 2: Planned timetable for PLICS (CTP) cost collection Date August 2018 Early September 2018 October 2018 Description Data validation tool update released Test of systems/collection readiness confirmation Provisional collection window opens 4 > Provisional 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 call connect date 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. A collection run by NHS Digital (to be confirmed) would be subject to a mandatory request 3 from NHS Improvement being accepted by NHS Digital. In this case, the expectation is that NHS Digital may disseminate data collected and/or created under that request. This may include dissemination to NHS Improvement, and potentially may also 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 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. In the event of the information governance rules and intended use of PLICS data being updated for collecting data in future years, the data collected this year will remain covered by the information set out here. We will not use of share the data for any purpose other than those listed above > Information governance

9 5.2. Sharing of data NHS Improvement may use the collected PLICS data for the purposes described above. We may also share your data with NHS England, NHS Digital or Health Education England for these purposes. In developing and populating a PLICS benchmarking solution, we may also share suitably aggregated data (determined in consultation with participating organisations) with 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 Freedom of Information requests Anyone can submit a Freedom of Information (FOI) request, and both NHS Improvement and NHS Digital are bound by the same rules as trusts. For a collection direct to NHS Improvement, we would be classed as the sole data controllers and would hold the information for the purposes of FOI. We would go back to the trust(s) in the first instance and provide a draft response for them to assess whether they have concerns. For a collection run by NHS Digital, NHS Improvement and NHS Digital would be joint data controllers. In this situation we would clarify the procedure in the event of an FOI request through further communication as soon as possible Data retention 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. 7 > Information governance

10 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). 4 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 > Applying the Healthcare costing standards for England

11 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 5 contain a list of the allocation resources and activities and how they map to those for collection. These are set out in Table 3 and Table 14 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 1: 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

12 8. Data specification 8.1. Extract specification We will publish an extract file specification alongside this collection guidance as soon as possible, setting out the exact structure of the CSV files to be produced for the collection. This will provide 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 File batching process of incident data The data extract should be split into 12 monthly files using the call connect date and time field. Incidents must only be reported in the month of the call connect 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 fail. 10 > Data specification

13 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

14 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 field for NHS number will only be collected should the collection be run by NHS Digital for information governance reasons. The fields for NHS number, Responder type and Organisation code (handover destination) can contain multiple entries if required. Therefore details of all responders that go mobile to an incident should be submitted. Table 6: Activity fields Data field name CSV field name Mandatory field Organisation code (code of provider) OrgId Y Organisation code (code of commissioner) OrgCom N 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 Clock start date and time CloStrt Y Job cycle duration (seconds) JobDur N Incident currency IncCcy N NHS number* NHSNoAmb N Responder type RTyp N Organisation code (handover destination) OrgHdvr N *NHS number is only to be collected if the collection is to be run by NHS Digital. 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. 12 > Data specification

15 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

16 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, 6 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

17 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. 15 > Treatment of specific scenarios and costs: additional guidance

18 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. 7 The reconciliation file should be generated directly from the costing system in a CSV or XML format. Details will be included in the extract specification files for both formats. We will publish these alongside this guidance as soon as possible. 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

19 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. 17 > Reconciliation tables

20 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 18 > Reconciliation tables

21 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 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. However, trusts should endeavour to complete as many fields as possible Submission of data files As discussed in the introduction, data submission will either be direct to NHS Improvement or to NHS Digital. Both organisations would use a secure electronic file transfer system. We will confirm specific details for this process as soon as possible. 19 > Data validation and submission

22 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 20 > Contact details

23 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