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Payment by Results data


What is Payment by Results data?

Payment by Results (PbR) is a system of paying NHS healthcare providers a standard national price or tariff for each patient seen or treated, taking into account the complexity of the patient's healthcare needs. The tariff received by the provider is adjusted to reflect the nationally determined market forces factor (MFF). This is unique to each provider and reflects the fact that it is more expensive to provide services in some parts of the country than in others. There may also be other adjustments to the tariff for long or short stays, for specialised services, or to support other PbR policy changes.

PbR data is sourced from the Commissioning Data Sets (CDS) which are held within Secondary Uses Service (SUS) data warehouse which is the same source as used for HES data. Like HES PbR contains admitted patient care, outpatient and A&E datasets.

The following table is an example of high level analysis performed using the PbR dataset, taken from PbR data analysis published by the HSCIC on May 15, 2012. It shows a breakdown of income (£ Billion) split by age and gender (April 2010 to March 2011).

payment-by-results-data-chart

PbR and HES: What's the difference?

There are a number of differences between the PbR data and HES data. The first difference relates to the cumulative nature of the HES extract with the year to date being extracted each time whereas PbR data is not cumulative and simply takes a single monthly snapshot at a given point in time (known as 'freeze') and never returns to extract that same data again in the future. This is in line with PbR policy which gives providers two months to submit the data before it is considered frozen to amendments. So in practice HES extracts April data and then April-May and then April-June and so on through the year whereas PbR data extracts April only and then May only and then June only and so on.

The HES data is subjected to additional processing to clean and de-duplicate the data whereas these same rules are not applied to the PbR data. Further, the PbR data does not contain an array of added value calculated fields that appear in the HES data, e.g. alcohol fractions.

The HES data is based around episodes that finish in the financial year whereas PbR data is based on spells that finished within the financial year so you will see only see finished episodes when they are part of a completed spell. So if you have episodes within a long multi episode spell which spans a couple of years you might see some records in the HES data many months/years before they appear in the PbR data.

The biggest benefit to the PbR data is that it contains tariff information so alongside activity you can also produce cost analysis using these data which is an option not currently available with the HES data.

The PbR data doesn't currently contain generic patient identifiers which would allow linkage to other data sets so the PbR data cannot be used to link between data sets.

Should I choose HES or PbR data?

In principle if you need patient activity data including tariff information then you should request for PbR data, otherwise we suggest that you use HES. More information about PbR data is available here.

PbR Data Guide

For any questions related to PbR data please contact the HES PbR Data service - pbrdataservice@hscic.gov.uk

How do I access national PbR data?

Extracts and tabulations of national PbR data are available via the HSCIC's Data Access Request Service

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