Payment and activity
Critical Care Minimum Data Set
In England, a Critical Care Minimum Data Set (CCMDS) is mandated for patients receiving critical care.This captures the organ support on a daily basis for each patient receiving critical care.
Health Resource Groups
The nationally mandated currency for critical care is Health Resource Groups (HRGs). In critical care these are derived from the organ support needed by patients and captured via the CCMDS. The HRG is allocated from this and is based on total organs supported for each patient's spell in critical care.
|These are the Health Resource Groups (HRGs) showing the number of organs supported|
|HRG Code||Number of organs supported|
Types of organ support
The type of organ support from which the HRG is derived includes:
Gastrointestinal (in CCMDS but does not influence the HRG allocated)
Who Commissions Critical Care?
Most critical care is commissioned by Primary Care Trusts (PCTs) and these are being replaced in 2013 by Clinical Commissioning Groups (CCGs). Commissioning intentions and plans are published each year.
Service Level Agreement and Monitoring reports
Activity and costs are reported by Trusts to PCTs (CCGs) on a monthly basis using (usually) discharged bed days. These reports are known as SLAM (Service Level Agreement and Monitoring) reports. These trigger payment by PCTs to Trusts.
Some services that include critical care are commissioned nationally or regionally. These include for example;
Both of these highly specialised services are provided (in normal circumstances) by a very small number of provider organisations.
Changes to commissioning
There are many changes underway in commissioning and if you require help or explanation please email and we will do our best to provide a useful reply