Weighted Bed Day currency & PLICS

What is the Weighted Bed Day currency for Specialist Neuro-Rehabilitation Services?

CM36 Patient Level Costing guidance for specialist rehabilitation services (Levels 1 and 2) was developed and published in 2022 with the aim of reflecting the agreed national model which uses the mandated complexity-Weighted Bed Day (WBD) currency for Level 1 and 2 services. This currency is based on the Rehabilitation Complexity Scale (RCS) which provides a validated method of allocating costs that are not directly allocated elsewhere within your PLICS costing software. Level 1 and 2 services routinely report activity data to the UK ROC Rehabilitation Outcomes Collaborative (UK ROC) which flow centrally to the national NHS data collection system and are used for contract monitoring and benchmarking of service quality and outcomes. 

How to use the PLICS data from your Specialist Rehabilitation Service

From 2023-5, this guidance has been trialled in the Local Cost Collection (LCC) setting by some early-adoption Trusts, and there has been further collaborative development between UKROC and the national leads for costing and pricing to bring these data processes into closer alignment. The process for PLICS reporting has been enhanced to improve focus on patient-care, while at the same time simplifying data collection and reducing the administrative burden for both the Service Providers and Costing Practitioners. This has led to the development of validated output which is simplified, accurate and useful for both patient care and costing purposes. The purpose of this document is to describe this methodology to support its wider application and adoption going forward.

It is the intention of NHS England (digital, data and technology functions) to integrate UK ROC software within future versions of the Canonical Data Model (CDM) thus allowing for seamless interoperability between UK ROC data and PLICS data. However, at present, this is not the case and so after importing the PLICS data sheet into your PLICS model, Costing Practitioners will need to ensure that duplicate records do not exist within APC FCEs. Costing Practitioners who elect to use the LCC methodology, as explained in this document, for both NCC and LCC, will benefit from being aligned with expected NHS CDM developments.

By way of explanation (no action necessary from Costing Practitioners): UK ROC produces two different sets of WBDs. One set is used by Providers and Commissioners and the other set (this set) is calculated for costing purposes. The number of WBDs calculated for costing purposes is known as ‘PLICS adjusted WBDs’ (or abbreviated as ‘P-adj-WBDs’) whereas the WBDs calculated for Providers and Commissioners are simply known as ‘WBDs’. The calculation of WBDs for costing purposes (ie ‘PLICS adjusted WBDs’) use a different set of ‘banding factors’ that apply only to variable costs as PLICS models will apportion fixed and overhead costs according to established costing principles whereas the ‘PLICS adjusted WBDs’ are only used to apportion variable costs (that cannot be directly applied to a patient).

Software provided by UK ROC, as used by your Specialist Rehabilitation Unit, now produces a monthly PLICS report in the form of an Excel spreadsheet. Within that spreadsheet there is a sheet named ‘dailyactivity’ which has been designed to import directly into local costing models in a format that ensures the correct and efficient reporting of the mandated WBDs currency for Specialist Rehabilitation services. Trusts participating in the trial are using these monthly PLICS ‘dailyactivity’ sheets for both national and local cost collection. An overview of the steps involved is given below.

Step 1:

All specialist and specialised (Level 1 and 2) rehabilitation units are registered with UK ROC and they routinely extract their data (activity, complexity and outcomes) from the locally held UK ROC software and send it to UK ROC each month.

Step 2:

UK ROC checks the data, and sends back a variety of reports, one of which will be the monthly PLICS report (in the form of an Excel spreadsheet). This report contains a sheet named ‘dailyactivity’ which holds the cumulative monthly PLICS activity data.

Step 3:

The specialist rehabilitation service uses their local UK ROC software to re-identify the PLICS report and passes this to their Costing Practitioner.

Step 4:

The Costing Practitioner uses the ‘dailyactivity’ sheet in the PLICS report to upload the weighted bed day activity for the period into their PLICS system.

Note: The complexity weighting is given in 5 bands depending on the total RCS-E score for that period. Different patients may have different weighting and the weighting for one patient may vary over time (and it can go either up or down).

Further Reading

• WBD currency and UK ROC PLICS activity data pdf

• Specialist rehabilitation services (2015) pdf

• Specialist Rehabilitation Commissioning presentation (2023)

Please feel free to contact UK ROC (LNWH-tr.ukroc@nhs.net) for help if needed.