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National Casemix Office Updates

Latest news, updates and developments from the service.

The National Casemix Office newsletter

The National Casemix Office has issued the pdf icon NCO Newsletter - September 2013 [382kb]

Previous NCO newsletter edition is available here:pdf icon NCO Newsletter - May 2013 [610kb]

The Plus Factor

A ground-breaking new version of healthcare resource groups (HRG4+) has been released, bringing with it greater recognition of different levels of patient complexity and comorbidity, writes Paula Monteith of the Health and Social Care Information Centre.

Read the article (from the April 2013 Edition of Healthcare Finance)

2013 Clinical Engagement Review

Expert Working Group (EWG) Clinical Leads

Every three years we carry out a review of our clinical engagement. The current term of office will come to an end on 31 March 2013. This allows us to re-affirm nominations of all Clinical Leads and gives us the opportunity to revisit the Terms of Reference and review the work we do with Clinicians.

Our Clinical Leads are nominated by their Royal Colleges, Societies and Professional Bodies and therefore represent these collectively. A recent exercise has been carried out throughout January and February 2013 to re-affirm their nomination or for them to nominate new representation.

pdf icon Download the EWG members list - March 2013 [445kb]

EWG Chair of Chairs Election

In addition, the Clinical Leads elect a new EWG Chair of Chairs to represent the interests of the National Casemix Office (NCO) Clinical Leads and EWG members in a number of areas, including policy and strategic forums. We are pleased to announce that Mr Ken Dunn, Consultant Burns and Plastic Surgeon at South Manchester University Hospital, has been elected to the role effective from 1 April 2013.

HRG4+ endorsed for use in the NHS for costing 2012/13 financial year

The NHS has used HRG4 to cost clinical activity since 2006/7 and to price such care from 2009/10. The latest iteration, HRG4+ was recently approved by NHS Commissioning Board, Monitor and the Department of Health to form the basis of the national reference costs collection for 2012/13.

HRG4+ is a significant enhancement to HRG4, which employs mechanisms of multiple procedure logic, interactive CCs (complications and comorbidities), and multiple matrices to enable the differentiation between levels of care complexity.

HRG4+ supports requirements outlined within the Health and Social Care Act 2012, by allowing for specialised services - provided in tertiary centres and NHS Centres of Excellence - to be distinctly identified and appropriately costed and funded, as well as enabling more effective planning and service redesign within local health economies.

Jill Cockrill, Information Design Consultant of the National Casemix Office, says:

"We are delighted that HRG4+ has been endorsed for use in the NHS for costing the 2012/13 financial year. The development of which has been a considerable team effort over the last twelve months, involving close working with the clinical community and colleagues representing national organisations.

It is gratifying to see such hard work is so successful, and that we have kept pace with the significant changes in the NHS to enable the improved costing of clinical care, which will underpin future funding mechanisms."

Use of Diagnosis Coding in an Outpatient Setting - Survey Report

In early 2012 the National Casemix Office conducted an online survey which enabled the NHS to share their thoughts on the introduction of recording diagnoses in an outpatient setting via the Outpatient Commissioning Dataset (CDS). The results have been investigated and its findings are detailed in the report which can be accessed via the link below. The report also contains an Options Appraisal that identifies a number of directions of travel in terms of classification development and possible next steps.

pdf icon Diagnosis Coding in Outpatients - Survey Report [474kb]

"Casemix in 2012/13 and beyond" presentation, HFMA Conference, 2011

At the annual HFMA Conference 2011, the Casemix Service from the Health and Social Care Information Centre presented a session entitled 'Casemix in 2012/13 and Beyond' which explored future Casemix developments.

Any questions regarding the content of the slides should be marked for the attention of the Casemix Service and sent to

Casemix team win international award for innovation

Principal information design consultant Paula Monteith accepted the award on behalf of the team at the annual conference of the Patient Classification Systems International (PCSI) conference.

The team won the award for their work developing HRG4+ and the concept of 'patient pathway groups' (PPGs) which seek to identify the typical pathway of care people with different types of long term condition might follow over a period such as a year.

In addition to the team award, Paula was invited to become a member of the scientific committee of PCSI, joining Ginny Jordan who has been a member since 2006. Ginny also represents Europe on the PCSI executive committee and was re-elected Treasurer at this year's conference.

The 27th PCSI annual conference was attended by some 200 delegates from 32 countries.

For more information about PCSI please visit their website pcsi international (external).

Casemix announce new Expert Working Group Chair of Chairs

Casemix Clinical Leads are nominated by their Royal College or professional body for a period of three years. The previous term expired on 31 March 2010, and we have liaised with all nominating bodies to review their representation. As a number of Clinical Leads have retired or stepped down at this point, ten new Clinical Leads have been appointed.

In addition, every three years the Clinical Leads elect a new EWG Chair of Chairs to represent the interests of the Casemix Clinical Leads and EWG Members in a number of areas, including the DH Clinical Advisory Panel. This year Bill Aylward, Consultant Ophthalmologist and for the last eight years Medical Director at Moorfields Eye Hospital, has been elected to the role.

pdf icon revised list of EWG members [232kb]

Getting the right mix

The NHS relies on a constant flow of information to improve services but has not always had such good mechanisms in place to capture and process data - read more.

pdf icon Getting the right mix [104kb] (Sept/Oct 2010 edition of nhe)

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