Payment by Results data

The HES extract service now includes Payment by Results (PBR) data.

Users can now request, with the appropriate authorisation and governance controls access to national level PBR 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 patients 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 derived 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.

SUS is delivered by The NHS Information Centre and NHS Connecting for Health.

Principal differences between PBR and HES

While the PBR dataset contains many of the same fields as the HES dataset there are some significant differences:

• PBR Admitted Patient Care (APC) data contains financial (tariff) information, which is not available in HES Inpatients.
• PBR data operates in a two phase reconciliation process to arrive at a final agreed position for a month, in comparison HES data is cumulatively refreshed each month going back to the beginning of the financial year.
  As HES and PBR data are taken in different ways they could each end up holding slightly different number of records.
  
• As well as HES data being refreshed each month, HES also contains many derived fields and has cleansing applied to the data to maximise its usefulness. PBR data has little or no cleansing applied to it.
• PBR APC data is available at both episode and spell level. A spell is an aggregation of all episodes from when a patient is admitted to when they are discharged. HES Inpatients data is only available at episode level, including some spell level fields.
• PBR APC data contains only those episodes that make up a finished spell compared to HES Inpatients data which holds all finished consultant episodes (FCEs). Therefore finished episodes from an unfinished (open) spell will be included in HES Inpatients data but not in PBR Admitted Patient Care data.
• PBR data does not contain generic patient identifiers to allow linkage to other data sets or across multiple years, this is possible with HES data.

The above lists the main differences between the two datasets, there will also be other subtle difference between the two which have not been listed.

Choose between HES and PBR data

In principle if you need patient activity data including tariff information then you may request for PBR data, otherwise we suggest that you use HES.

Further information on Payment by Results data is available here.

You may also find the front door decision tree useful, it is designed to guide you to the most appropriate HES or PBR data considering your requirements and permissions.

To submit a request for PBR report data, click here.

To submit a request for HES tailor-made report data, click here.