Andrew Bowdler, Principal Data Analyst at MIAA responds to a recent piece in Health Service Journal on the use of data in the NHS.

In a recent thought-provoking article for the Health Service Journal, journalist Steve Black issued a timely warning: the government’s emphasis on using NHS data to drive drug and therapy development may miss the bigger prize — improving existing NHS services. As data professionals in the NHS, this should prompt some urgent reflection.

We’re standing at a crossroads. While health data partnerships with the private sector may one day yield breakthrough treatments, the most immediate and impactful gains lie closer to home — in our own theatres, clinics, wards, and recovery beds.

The Hidden Opportunity: Service Improvement Through Data

Steve Black points out that “using data to drive innovation is sexy, but using it to drive improvement has much larger potential gains.” This statement captures a profound truth. As internal NHS data professionals, we see the daily operational pressures: rising costs, delayed discharges, long A&E waits. Yet, we often have access to goldmine datasets — rich, underused resources like PLICS (Patient-Level Information and Costing Systems), SUS (Secondary Uses Service), and waiting times data — that could tell us why these problems persist and how to fix them.

A Case in Point: Variation in Unit Costs

Take the VB11Z HRG code — "no investigation with no significant treatment" in A&E. This should be one of the most uniform, low-cost activities. Yet, as Steve notes, hospital-reported costs vary wildly — some are double the national tariff. This isn't an isolated outlier; it's a pattern seen across many HRGs. Behind that variation is a story: operational differences, inefficiencies, or resourcing issues that are both fixable and measurable.

And it’s not just about costs. These variations hint at service quality, patient flow, and outcome differences that we have the tools to address.

What’s Stopping Us?

Despite the power of PLICS and patient-level datasets, their use for decision-making remains sparse. Why?

• Low trust in data quality
• Lack of analytical capacity within provider organisations
• Cultural barriers to exposing variation
• Shifting incentives post-PbR (Payment by Results)
• Top-down cost reduction targets that risk cutting analysts instead of empowering them

This final point is crucial. Many of the very teams that could unlock value through better data use — costing teams, analysts, improvement specialists — are themselves under threat in current cost-cutting cycles.

A Way Forward: Five Recommendations

Let’s turn this around. Here’s a practical, values-driven approach for NHS data professionals to lead the change:

1. Champion the Use of PLICS Data in Improvement Work

Start with high-volume, high-variation services (e.g., elective orthopaedics, emergency care). Use cost drivers to identify actionable differences between sites. Tools like GIRFT, Model Hospital, and RightCare can supplement this analysis, but local teams must own and understand the insight.

2. Develop Cross-Functional Improvement Teams

Pair analysts with clinical leads, operational managers, and finance staff. Don’t let data live in silos. Data stories resonate more when clinicians see themselves — and their patients — in the numbers.

3. Build Trust in Data Through Transparency

Make variation visible — even uncomfortable variation. Use dashboards to show HRG-level cost, theatre time, LOS, and diagnostics per procedure. Contextualise it. Then collaborate on solutions.

4. Defend and Invest in Analytical Capacity

Highlight the ROI of good analysis. Show how one insight from costing data can release tens of thousands of pounds or reduce waiting times by weeks. Make the business case for retaining and growing analytical roles.

5. Push for System-Level Access to Data That Drives Efficiency

Make the case for improved access to datasets like detailed PLICS and patient flow data. Public versions of cost data are helpful but limited. Enable better integration across ICSs and Trusts.

Let’s Shift the Narrative

The NHS doesn’t just need data scientists to develop the next AI-driven drug. It needs local analysts, business intelligence leads, costing experts, and informatics professionals who can fix the services we already run. Every delayed discharge, extended inpatient stay, or inefficiency in diagnostics has a cost and a human consequence.

So let’s reclaim the power of our data — not just for future cures, but for today’s patients.

Key References

• Black, S. (2025). The government’s focus on using NHS data to develop new drugs misses the bigger opportunity. Health Service Journal. HSJ
• HFMA (2022). PLICs Explained. Healthcare Financial Management Association. What is patient-level costing? | HFMA
• NHS England. National Cost Collection data. NHS England » National Cost Collection for the NHS