Cost to send a patient to the UK to remove a brain tumour (FOI)

​​​Request

I would like to know the full cost to Health and Social Services to send a patient to the UK to remove a Meningioma WHO Grade 1 Brain Tumor, OPCS code A3810

Including all of the following elements:

Patient transport and accommodation including relative if travelling with them to and from UK Hospital

UK hospital costs to be broken down as follows:

UK hospital accommodation charges

UK hospital operating theater charges

UK hospital operating theater consumables

UK hospital pathology

UK ospital physiotherapy

UK hospital CT/MRI/ scan

UK hospital intensive care / High dependency care

UK hospital anesthetic fee

UK hospital neuro surgeons fee

Response

UK Hospital Costs

Neurological cases are predominantly sent to The National Hospital for Neurology and Neurosurgery part of the University College London Hospitals NHS Foundation Trust.

Where the department contracts services on behalf of patients from NHS providers, the department will be invoiced for those services at NHS tariff plus local MFF rates.

The Market Forces Factor (MFF) applied by each hospital is representative of the additional costs an NHS hospital may incur and will therefore vary by hospital provider. The National Hospital for Neurology and Neurosurgery attracts a 29.8% uplift on tariff, representing a provider MFF of 1.297607

In this instance, it is not possible to provide an estimate of costs for OPCS code A3810 as the NHS does not use OPCS codes for billing and payment purposes. 

The currency for admitted patient care and A&E treatment in the UK is the Healthcare Resource Group or HRG. 

HRGs are clinically meaningful groups of diagnoses (ICD 10) and interventions (OPCS 4) that consume similar levels  of  NHS  resources.  

With  26,000  codes  to  describe  specific  diagnoses  and interventions,  grouping  these  codes  into  HRGs allows  tariffs  to  be  set  at  a  sensible  and workable level.

Download a simp​le guide to payment by resul​ts on GOV.UK (size 1mb)

We did ask The National Hospital for Neurology and Neurosurgery to estimate what a HRG for this intervention might equate to but in the absence of an ICD 10 (patient level information relating to the underlying diagnosis) it is not possible to produce this for you with any degree of accuracy.

Had we been able to obtain a cost for this treatment, you asked that these costs be further split out to show a detailed breakdown as to where individual costs had been apportioned. 

Given the complexity and make up of the NHS billing system, it would not have been possible to separate these costs out in the way you have described as these items have been “bundled together” and are presented to us within the NHS tariff as one cost within the HRG.

Unfortunately, it is simply not possible to provide accurate costing information for inpatient episodes within the existing NHS framework prior to treatment for reasons previously stated. 

At best, any price that could be produced would be ‘theoretical’ and subject to change as prices vary considerably as a result of (but not limited to):

• any unintended stay in an ITU
  
• any length of stay longer than expected within the tariff price
  
• any patient specific co-morbidities that add to the tariff price ie obesity, diabetes etc
  

Further guidance on how procedures are costed and how money moves around the NHS system can be found within the guide above.

The full list of NHS tariff prices is available as a public document below. 

NHS national tariff payment system on UK government website

Cost of travel to the UK

If this episode was for an elective surgical case, then the cost of a flight to the UK (London City) via Blue Island would be £69 per person.

If clinically indicated, the cost of charter aircraft would be in the region of £2,500 each way. 

Again, the price here would vary considerably dependent on clinical team required, type of aircraft available and time of day of the flight. 

A cost of £2,500 per leg of the journey should be taken as a guide price only.

Cost of accommodation in UK

Patients receiving inpatient treatment at a UK hospital will normally be accommodated free of charge within the hospital as the accommodation cost is already built into the tariff. 

Ordinarily one would not expect to see additional charges for patient accommodation associated with an inpatient stay.

Accommodation for escorts is not provided for within the existing departmental policy unless the patient (whom they are accompanying) is in receipt of income support at the time of travel, when a maximum of two days accommodation may be authorised by the department. 

HSSD’s full policy on patient travel can be viewed below. 
Download patient travel charges policy (size 240kb)

Additional comment

The department would be happy to discuss with patients or relatives (with consent) any cases where referral to the UK has been indicated. 

Should patients or family have any concerns then they are advised to get in touch with the hospital’s Oversees Treatment Office who can triage the query and arrange for the most appropriate person to respond to any ongoing concerns patients or relatives might have.