Finance heads from NHS Trusts across England believe that costing at patient level is crucial, if Trusts are to optimise their performance and ensure the best use of available funding and resources.

According to members of the Ardentia patient level and information costing user group, more detailed and accurate data - and more of it - will not only improve financial reporting and help ensure costs are kept in line with income for the activity undertaken, it will also eliminate inefficiencies in clinical care and improve care delivery at Trust level.

Patient level costing is giving clinical managers greater visibility of where exactly costs are being incurred. This improves clinical ownership of resource decisions and ensures departments run on a robust business footing.

According to Fiona Boyle, finance manager at Southampton University Hospitals Trust: "By basing financial reporting upon actual costs incurred, what we will see is a virtuous circle, whereby cost reapportionment will lead to more accurate cost models, and an improved understanding for finance staff, clinical managers and the executive board of the activity against income. This in turn will help improve funding policy in conjunction with commissioners.

"Better quality data is at the heart of this, and Ardentia's business intelligence solutions allow trusts to drill down to analyse where costs are being incurred at a patient level and also within the different service lines, to identify accurately the costs associated with care delivery."

Keith Sherratt, head of the Ardentia PLICS development team added: "There is intensive development going on within many Trusts to develop patient level costing and service line reporting solutions. Ardentia's user groups span mental health, acute and primary care and enable us to share best practice and develop new and innovative ways of improving financial reporting, and as a result overall trust management."

User group members have already made significant progress in service line reporting, which has given them the ability to identify the financial performance of each department, in order to identify where operational improvements and efficiencies can be made.

Where they have fully implemented patient level costing they can drill beyond Service Line to find where, in actual patient care, specific anomalies are arising. This enables both clinicians and managers to focus their attention on those areas where they can generate the most significant improvements.

This approach has delivered trust-wide benefits. Clinicians tasked with increased responsibility for the effective management of their department can identify if they are operating on a profit or loss basis and can then take timely measures to improve operational efficiency and ensure the best use of the available resources allocated to them.

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