This data briefing from Dr Foster Intelligence shows how primary care spending on healthcare resource groups varies across strategic health authorities. The research covers year-on-year changes in the first quarter of 2006. It is based on the number of spells coded with HRGs and covered by payment by results.

This data briefing from Dr Foster Intelligence shows how primary care spending on healthcare resource groups varies across strategic health authorities. The research covers year-on-year changes in the first quarter of 2006. It is based on the number of spells coded with HRGs and covered by payment by results.

The change in spending for each SHA is an average 9.6 per cent increase, although it is important to remember that, as more work is coded, spending and number of spells is likely to increase. Individual tariffs will have changed in some instances, creating another reason for increases in spending.

The variation in the rises across SHAs ranges from 14.91 per cent for South East Coast to 1.15 per cent for South Central. Not surprisingly, South East Coast also shows the largest rise in spells coded with HRGs (up 18.37 per cent). The increase for South Central is just 4.09 per cent. With the challenge of reining in spending across the NHS, these differences geographically should cause concern.

Spend on elective work overall has increased by 7.37 per cent, while for non-elective work the figure is 3.97 per cent. As usual, the seasonal effect on this spending around the end of the financial year is of concern.

For the average cost of procedure in each group of HRGs, there seems to be a stabilising of tariff, with only a small variation year on year.

In elective spend, cardiac surgery and primary cardiac condition shows the highest fall, by 6.46 per cent. Spinal surgery and primary spinal conditions shows the highest rise (by 4.98 per cent).

For non-elective spend the most significant fall is eyes and periorbita (down by 3.36 per cent). The biggest rise is urinary tract and male reproductive system (up by 3.14 per cent).

Results of potential 'gaming' analysis at Dr Foster Intelligence highlight a number of trusts' coding patterns that may be cause for concern.

From the beginning of next year, primary care trusts will be able to access information on these coding oddities, which may range from innocent poor-quality coding to deliberate exaggeration of activity to generate greater revenues. -

Marc Farr is product development manager at Dr Foster Intelligence (phone 020 7330 0472 or visit drfosterintelligence.co.uk).