Data top of the agenda at the HFMA Costings Conference

The challenges the NHS face are many, and a matter of daily national debate. The rising demand caused by an ageing population, an increasingly constrained supply of workforce, and rising costs associated with consumables and estates are all challenges that are forcing trusts to think imaginatively about their approaches.

The HFMA Costings conference (Costing conference 2024 | HFMA ) which took place on April 17th in Manchester typically provides a platform for finance managers across the country to exchange costing case studies and discuss policy; as in other forums the use of technology and innovative approaches to tackle these long-standing challenges are taking centre stage.

The importance of data and its potential for improving efficiency was a core theme across several talks. May Mengyu Li from NHSE provided a national overview, touching on key points including the challenges of trusts operating on a deficit, productivity being impacted by thresholds for admission going up as demand continues to grow, and how tech can enable change across systems. With £3.4bn announced in the Spring budget for NHS digitisation, there is a genuine commitment to make investments that will help the trusts use their data to drive efficiency.

Main takeaways

• The two main challenges associated with technology-led interventions are recognised to be funding, and operational reality on the ground. In the context of a cash-constrained environment the conversation must focus on how to better allocate existing resources rather than deploy new initiatives. Tech must also enable clinicians rather than burden them with additional admin.

• Patient-led digitisation is at the forefront of people’s minds, with increasing awareness of the potential savings to trusts through both reduced admin and improved outcomes (better attendance at slots etc).

• Even those trusts who make good use of their data are unsure about their approach – some would use it to confirm or dispel anecdotal evidence from clinicians, whereas others would take an exploratory approach, looking for insight through patterns.

 The various case studies highlighted the challenge of how best to use data to make better decisions. The finance team from Lancashire and South Cumbria discussed financial recovery, and how it has been assisted by insights derived from different datasets. They touched on Patient-Level Information and Costing Systems (PLICS)  as a dataset with potential for yielding insight both about population health and financial recovery, a point raised in other talks as well. In some advanced cases, systems are looking at clinical reconfiguration based on the insights derived from data, and others are looking at general efficiency (e.g. comparing time in theatre across systems).

While trusts have focused considerable effort into better using the resources at their disposal, there is only so much efficiency that can be squeezed out of the existing system; it is here that debate is slowly shifting to population health management and preventative care. In this space, there are clear ways in which better allocation of funds and better use of existing data can have significant impact. 

The panel on health inequalities touched on this, highlighting the requirement for spending differently rather than spending more, and whether the best route create positive outcomes was to look for patterns in the data or to validate hypotheses following discussions with clinicians or patient groups. They noted that trends discovered in one ICB did not necessarily hold true in others (e.g. correlation between deprivation and A&E use). There was also an acknowledgement that there is as yet only a rudimentary understanding of the broader metrics around demand reduction, as using a financial lens is insufficient without the broader social and economic picture (e.g. demand for high dependency drugs is low cost to systems but very high cost to the community).

There is agreement that there is a wealth of data the NHS holds that could help feed into preventative measures and reduce costs, as well as support existing efficiency drives. Keeping the momentum to find the right platforms, processes and targeted areas will be key even as trusts are trying to simultaneously focus on everyday challenges.