Using a Patient Level Information and Costing System (PLICS) to Add Grip and Improve Performance

HCS decided to improve their financial intelligence and build better links between the finances and the clinical services. In-Form Solutions were commissioned to provide the specialist support to decide on whether to implement a PLICS system, and subsequently to tender for the software, design, implement and report using it.

Jersey’s health system is unlike the NHS. Difficulties included a lack of data recorded or low data quality, both needing workarounds. There was also a steep learning curve for all staff. Opportunities included autonomy (having no fragmented providers and no commissioner) and being virtually “whole system”, including social care and ambulance.

In-Form Solutions led by Steve Kelly who is one of the most experienced and skilled qualified accountants in this highly specialised field. Technical costing advice, project management, training, clinical coding and software skills (including SQL and the NHS HRG Grouper) were essential given much of this was new to HCS. Also essential was strong clinical service knowledge from an acute and non-acute background, to build clinical engagement.

The model now covers seven financial years, with our support for each of these. Due to government restructures, the pandemic and the prioritisation of a financial recovery plan we were asked to take a more extensive role in producing recent annual models, which we were very happy to do.

Having granular cost intelligence is not enough – the output then needs to be analysed and used, with a bridge to help deliver value for money improvements and financial balance in a wider context. We provided an annual report with extensive detail to explore these issues and give HCS something tangible to take forward.

All output from this multi-year project has been formally signed off and the client is very happy with the results.

The outcomes:

• A PLICS model with Qlikview dashboards covering 2016 onwards, containing cost, income and activity.
• Benchmarks to give variances against the NHS (at patient level and all levels above).
• Demographics and other non-financial indicators of relevance including by the long-term conditions of each islander (a database is kept by the government and the resulting healthcare provided can be studied in PLICS).
• A report analysing the unit costs, variances and opportunities for efficiency, productivity and value increases.
• A Long Term Costing Strategy to bring all this together and ensure strong clinical engagement.

“I have worked with the team from In-Form Solutions for a number of years on a wide variety of assignments. The team has provided a reliable and efficient service including services which add real value due to their extensive contact base and experience. They have always delivered their assignments in a timely manner, and I consider them as really good value. We would positively recommend them to any healthcare provider or commissioner” .