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Approved Costing Guidance review and feedback - acute, mental
health and community services
Overview
Acute, mental health and community sector survey
Please note this survey relates only to acute, mental health and
community trusts. Ambulance trusts should complete this survey.
This survey is part of the review and feedback exercise of the Approved Costing
Guidance (previously known as 'the consultation') which gives all stakeholders
the opportunity to express their thoughts on the proposed standards with regard to
their practicality, achievability and implementation. For the first time, we are also
asking more detailed questions relating to specific changes made to individual
standards and to the technical document.
We appreciate your time in completing this survey. If you do not have time to review
all of the material, we would ask that you prioritise changed areas and those that are
most important to your trust. There is a link at the bottom of this page to the full suite
of Tranche 1 documentation on the Online Learning Platform
(including one which summarises the major changes).
In giving your answers please remember to include the paragraph number when
referring to specific areas of the documentation.
Contents Introduction ......................................................................................................................... 2
Overview of Standards ....................................................................................................... 3
Integrated Information Requirements ................................................................................ 4
Integrated Costing Processes ............................................................................................ 7
Integrated Costing Methods ............................................................................................. 11
Integrated Technical Document ....................................................................................... 17
Acute Costing Methods .................................................................................................... 21
Acute Costing Approaches .............................................................................................. 22
Mental Health Costing Methods ....................................................................................... 24
Community Costing Methods .......................................................................................... 27
General Comments ........................................................................................................... 30
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Introduction
1.What is your name?
2.What is your email address?
If you enter your email address then you will automatically receive an
acknowledgement email when you submit your response.
3.What is your organisation?
4.In which sector does your organisation work? (tick all that apply)
Acute
Mental health
Community
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Overview of Standards
1.Please rate the Tranche 1 documentation of the Approved Costing Guidance
according to the following criteria
Clarity of language in the documents
Ease of navigating the documents
Ease of understanding the aim of the documents
Standards having a logical approach
Completeness of the standards
Soundness of the technical content
2.The PLICS collections requirements have been removed from the standards to
avoid duplication and reduce confusion. Do you support this change?
Yes No
3.Each standard grouping has an introduction, which has been shortened where
possible. Which statement best represents your opinion on the introductions?
I prefer the shorter introductions.
I like the introductions in the existing standards; they should be reinstated.
The introductions aren’t necessary; they should be removed.
4.Development area: We currently do not have costing methods for Diagnostics.
Would you benefit from the development of a standard, or standards, covering this
area? For example, on pathology or diagnostic imaging?
Yes No
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Integrated Information Requirements
1.IR1: Collecting information for costing. Please indicate how closely you feel this
standard meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
2.IR1: This standard is now integrated for acute, mental health and community
services. Does this make it easier to manage all the feeds?
Yes No
3.IR1: Does the standard include enough detail on how to treat each feed?
Yes No
If you answered yes, would you suggest removing any areas? If so, which ones?
If you answered no, which areas do you think should be strengthened and how?
4.IR1: Critical Care: We have given further information to Feed 6a, 6b and 6c for
critical care, to accommodate the different ways critical care is recorded in PAS and
therefore how costing software is able to attach cost to the critical care record. Is the
standard improved in this area?
Yes No
5.IR1: Critical Care: Does it cover the way your trust has both information and
costing process set up? (If you have any examples of how either factor might show
critical care differently to the standard, please indicate here in your comments, and
we will contact you)
Yes No
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6.IR2: Managing information for costing. Please indicate how closely you feel this
standard meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
7.IR2: Data quality is repeatedly raised as a challenge for costing practitioners. Does
this standard give clear guidance on how to work with your trust to improve data
quality?
Yes No
If you answered no, how would you suggest improving it? (please use examples
from your trust)
8.IR2: This standard has not had major changes this year. Are there any areas you
think require urgent review? (please specify paragraph numbers where appropriate)
9.IR3: Using patient level information as part of the decision-making toolkit (new
standard). Please indicate how closely you feel this standard meets the following
objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
10.IR3: Does this standard cover all usual uses of PLICS information?
Yes No
If no, what could be added?
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11.IR3: Is the standard clear about which are the prescribed elements, and which
are superior methods?
Yes No
12.IR3: The intention is to use case studies to illustrate this standard, so that trusts
can share their good work with others. Do you have any case studies we can include
in the companion to this standard?
Yes No
13.IR3: Is the standard clear about when this standard will be included in the
assurance process?
Yes No
14.IR3: Do you have any comments on individual paragraphs in this standard?
(please specify paragraph numbers where appropriate)
15.IR Appendices: We have created appendix 1 by moving it from the technical
document. Do you support this change?
Yes No
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Integrated Costing Processes
1.CP1: Role of the general ledger in costing. Please indicate how closely you feel
this standard meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
2.CP1: Paragraph 11 - The table from the integrated technical document has been
moved into this standard. This is to reduce the size of the integrated technical
document. Do you support this change?
Yes No
3.CP1: This standard has not had major changes this year. Are there any areas that
you think require urgent review? (please specify paragraph numbers where
appropriate)
4.CP2: Clearly identifiable costs. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
5.CP2: Is the new section on the two-level compliance for GL to CL mapping clear?
Yes No
If you have any comments on two-level compliance, please add them here
6.CP2: Is it clear in ‘Allocating type 1 support costs’ that type 1 support costs need to
be separated from patient-facing resources in collection?
Yes No
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If you have any comments on allocating type 1 support costs, please add them here
7.CP3: Appropriate cost allocation methods. Please indicate how closely you feel
this standard meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
8.CP3: Paragraph 39 has been amended to a permissible substitution rather than a
superior method. Do you support this change?
Yes No
9.CP3: The Type 2 resource SPR105 CNST payment has been changed to a patient
facing resource to be linked to activities. Do you support this change?
Yes No
10.CP3: The activity SPA149 CNST has been deleted. The cost of CNST should
now be treated as a patient-facing resource and CP3.3 shows how this can be linked
to activities in the same way as consultant costs. Do you agree that CNST should
not be classed as an activity?
Yes No
11.CP3: Do you have any further comments on this standard?
12.CP4: Matching costed activities to patients. Please indicate how closely you feel
this standard meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
13.CP4: Is this standard clear?
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Yes No
14.CP4: Is there the right amount of detail on the matching process?
Yes
No - there's not enough detail
No - there's too much detail
If you answered no, please let us know what you would like added or removed
15.CP4: Do you have suggestions for additional areas?
16.CP5: Reconciliation. Please indicate how closely you feel this standard meets the
following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
17.CP5: This standard has not had major changes this year. Are there any areas you
think require urgent review? (please specify paragraph numbers where appropriate)
18.CP6: Assurance of cost data. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
19.CP6: There has been detail added in regarding assurance on information
governance. Do you support this change?
Yes No
20.CP6: This standard has not had major changes this year. Are there any areas you
think require urgent review? (please specify paragraph numbers where appropriate)
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21.Changes to names of Costing Processes
The following are suggested new names for each of the six costing processes.
Please indicate whether you support or oppose changing to the new name
CP1: Ensuring the correct cost quantum
CP2: Clearly identifying costs
CP3: Allocating costs to activities
CP4: Matching costed activities to patients
CP5: Reconciling cost and other data
CP6: Assuring cost data
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Integrated Costing Methods
1.CM2: Incomplete patient events. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
2.CM2: This standard has not had major changes this year. Are there any areas you
think require urgent review? (please specify paragraph numbers where appropriate)
3.CM5: Theatres & special procedure suites (SPS). Please indicate how closely you
feel this standard meets the following objectives
It's practical to use
aims are achievable
It can be fully implemented
It delivers transformative change
4.CM5: This standard has had a full rewrite following a Costing Expert Working
Group. Do you feel this is an improvement on the existing standard?
Yes No
5.CM5: Does this standard clearly explain how to treat the costs of staff working in
theatres?
Yes No
If not, how could we improve it?
6.CM5: The standard now combines guidance for medical and non-medical staff.
Does this give enough detail?
Yes No
If not, what other detail should it give?
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7.CM5: Should this standard be published as a replacement for the existing CM5?
Yes No
8.CM6: Critical care. Please indicate how closely you feel this standard meets the
following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
9.CM6: Does this standard clearly explain how to cost the different units of:
a. critical care
b. high dependency
c. patients on general wards
d. critical care outreach
e. pre/post-operative support teams using critical care staff
f. how to cost for critical care staff attending A&E
g. transport
If you answered 'partially' for any of the above, please give your reasons here
10.CM6: We have changed the costing of critical care transport at patient level to be
a superior method. Do you support this change?
Yes No
Please let us know if you think this change is not clear in the standard
11.CM7: Private patients and other non-English NHS funded patients. Please
indicate how closely you feel this standard meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
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12.CM7: This standard has not had major changes this year. Are there any areas
you think require urgent review? (please specify paragraph numbers where
appropriate)
13.CM8: Clinical and Commercial Services or Received. Please indicate how closely
you feel this standard meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
14.CM8: The standard has been renamed to aid understanding. Do you support this
change?
Yes No
15.CM8: The terminology 'contacted in' and 'contacted out' has been revised. Do you
support this change?
Yes No
16.CM8: The direct access and screening programme guidance will be moved to a
new standard. Do you support this change?
Yes No
17.CM8: Do you have any further comments regarding this standard?
18.CM10: Pharmacy and medicines. Please indicate how closely you feel this
standard meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
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19.CM10: This standard has not had major changes this year. Are there any areas
you think require urgent review? (please specify paragraph numbers where
appropriate)
20.CM11: Integrated providers. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
21.CM11: This standard has not had major changes this year. Are there any areas
you think require urgent review? (please specify paragraph numbers where
appropriate)
22.CM12: The income ledger: With the agreement of the Costing Expert Working
Group this standard has been revoked because it is not required in its current format.
Do you support this change?
Yes No
23.CM14: Group sessions. Please indicate how closely you feel this standard meets
the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
24.CM14: This standard has been updated to clarify treatment of group contacts
where patient identifiable information should be available, and groups (such as
education groups) where no patient information is recorded. Is this distinction and
the treatment of costs clear?
Yes No
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25.CM14: Please let us know if you are aware of multiple staff running group
sessions in your locality
26.CM15: Cost classification. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
aims are achievable
It can be fully implemented
It delivers transformative change
27.CM15: This standard has not had major changes this year. Are there any areas
you think require urgent review? (please specify paragraph numbers where
appropriate)
28.CM20: Costing GP services in secondary care settings. Please indicate how
closely you feel this standard meets the following objectives
It's practical to use
aims are achievable
It can be fully implemented
It delivers transformative change
29.CM20: This standard has not had major changes this year. Are there any areas
you think require urgent review? (please specify paragraph numbers where
appropriate)
30.CM21: Clinical Non-Pay Items (new standard). Please indicate how closely you
feel this standard meets the following objectives
It's practical to use
aims are achievable
It can be fully implemented
It delivers transformative change
31.CM21: Does the standard state clearly which clinical non-pay items should be
identified to patient level?
Yes No
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32.CM21: Does the standard state clearly which clinical non-pay items may be
identified to patient-level as a superior method?
Yes No
33.CM21: Does the standard state clearly how to allocate items that are not
expected to be identified to patient-level?
Yes No
34.CM21: Does this standard reduce repetition in other standards effectively? Or
would you rather the treatment of clinical non-pay items is repeated within the
standard describing the service for ease of reference?
Keep this standard – it’s easier to reference
Revert to the formatting in the published standards
35.CM22: Audiology services (new standard). Please indicate how closely you feel
this standard meets the following objectives
It's practical to use
aims are achievable
It can be fully implemented
It delivers transformative change
36.CM22: Does the standard clarify how to treat direct access audiology separately
from audiology support of ENT (and other specialties)?
Yes No
37.CM22: Does the standard describe how the activity takes place in your trust?
Yes No
38.CM22: Do you have the information required to disaggregate the costs of direct
access audiology from support to ENT (and other specialties)?
Yes No
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Integrated Technical Document
1.The Integrated Technical Document: please indicate how closely you feel this
document meets the following objectives
It can be fully implemented
The information is technically sound
It's practical to use
The aims are achievable
Can help deliver transformative change
2.Do you use the contents page?
Yes No
3.Do you find the transition path helpful for planning your 3-year phased
implementation?
Yes No
4.Is the costing diagram easy to understand?
Yes No
5.Do you find the likely sector column helpful in understanding which sections apply
to your sector?
Yes No
6.Do you use this filter to manage use of the large spreadsheets?
Yes No
7.Do you use the ‘My Organisation’ column to tailor spreadsheets to include the
services/resources/activities that your trust needs?
Yes No
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8.IR1.1 has had several columns removed as the information is duplicated in costing
standard IR1. Do you support this change?
Yes No
9.CP2.1: Do you complete the whole GL to CL exercise as part of your costing
process?
Yes No
If you answered no skip to question 11
10.CP2.1 Do you find the standardised cost ledger easy to apply as part of your
costing process?
Yes No
11.CP2.1 Does the GL to CL mapping process enhance your knowledge of the costs
in your organisation?
Yes No
12.CP2.1 On advice of the Costing Expert Working Group, the costing process for
GL to CL mapping has been spilt into two levels of compliance. Do you support this
change?
Yes No
13.CP2.1 The column ‘final audited accounts collection reconciliation codes’ has
been removed. Do you support this change?
Yes No
14.CP2.2 The allocation methods have been updated. Do you support this change?
Yes No
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15.CP2.2 Allocation methods have been combined where similar duplications
existed. Do you support these changes?
Yes, some of them
Yes, all of them
No
If you answered 'Yes - some of them' please indicate which changes you support
16.Are there any tabs in the technical document that you feel are not useful or would
be best placed in a particular standard?
17.Should CP4.1 be combined for all sectors or left as sector specific tabs?
Combined
Sector specific
18.The Theatres feed on IR1.2 has been amended to reflect feedback on the
availability of data on which staff are present in a particular theatre session/operation
at any one time. Does this make the costing of theatres more practical?
Yes No
19.Spreadsheet CP4.1 has been updated to include matching of auxiliary feeds
using ‘unique patient id/contact’ to ‘unique patient id/contact’, as the first matching
criteria.
a. Do you have this information in your feeds to use?
Yes No
b. Does this help to improve your matching process?
Yes No
20.CP3.3 Now includes the resource SPR105 CNST payment as a patient facing
resource and is linked to the same activities as ‘consultant’ with a step 1 and step 2
allocation method.
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a. Do you support these changes?
Yes No
b. Do you believe the resource should be linked to any other activities?
Yes No
If you answered yes, please explain your reasons
21.As explained in the previous question, the step 1 and 2 allocation methods for
CNST are now in 3.3. Do you agree with the wording in these steps?
Yes No
If you answered no, please explain how you would improve the wording
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Acute Costing Methods
Please note that this section applies only to acute providers
1.CM1: Consultant medical staffing. Please indicate how closely you feel this
standard meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
2.CM3: Non-admitted patient care. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
3.CM4: Emergency department attendances (including A&E, minor injury unit and
walk in centre). Please indicate how closely you feel this standard meets the
following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
4.CM9: Clinical MDT meetings. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
5.These standards have not had major changes this year. Are there any areas you
think require urgent review? (please specify paragraph numbers where appropriate)
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Acute Costing Approaches
Please note this section applies only to acute providers
1.CA1: Tonsillectomy. Please indicate how closely you feel this standard meets the
following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
2.CA2: Cochlear implant surgery. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
3.CA3: Renal dialysis. Please indicate how closely you feel this standard meets the
following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
4.CA4: Renal transplant. Please indicate how closely you feel this standard meets
the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
5.CA5: Chemotherapy. Please indicate how closely you feel this standard meets the
following objectives
It's practical to use
The aims are achievable
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It can be fully implemented
It delivers transformative change
6.CA6: Cataract procedures. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
7.CA7: Orthopaedics. Please indicate how closely you feel this standard meets the
following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
8.Table CA7.1 uses multiple pages. Do you support reducing this to a shorter
example?
Yes No
9.CA8: Maternity . Please indicate how closely you feel this standard meets the
following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
10.The standards in the Acute Costing Approaches have not had major changes this
year. Are there any areas you think require urgent review? (please specify paragraph
numbers where appropriate)
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Mental Health Costing Methods
Please note that this section applies only to mental health providers
1.CM1: Medical staffing. Please indicate how closely you feel this standard meets
the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
2.CM1: Does this standard give enough detail to cost your services appropriately?
Yes No
3.CM1: We propose moving paragraph 17 to permissible substitution. Do you
support this change?
Yes No
4.CM1: Paragraph 17 also includes the following statement: 'All NHS organisations
have a financial duty to record payroll information in their general ledger, and to map
staff costs to the separate categories in the financial accounts. Therefore, the
information in the general ledger will be sufficient to understand staff types for
costing to more detailed resources'. Are you supportive of deleting this paragraph
and adding into the glossary?
Yes No
5.CM3: Non-admitted patient care. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
6.CM3: Does this standard give enough detail to cost your services appropriately?
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Yes No
7.CM3: Using this standard are you able to cost learning disabilities NAPC services
appropriately?
Yes No
8.CM9: Clinical MDT meetings. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
9.CM9: Have you implemented this standard yet?
Yes No
10.CM9: Does this standard give enough detail to cost your services appropriately?
(irrespective of whether you have implemented it)
Yes No
11.CM13: Admitted patient care. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
12.CM13: Does this standard give enough detail to cost your services appropriately?
Yes No
13.CM13: Using this standard are you able to cost learning disabilities APC services
appropriately?
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Yes No
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Community Costing Methods
Please note that this section applies only to community services providers
1.CM3: Non-admitted patient care. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
2.CM3: Does this standard give enough detail to cost your services appropriately?
Yes No
3.CM13: Admitted patient care. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
4.CM13: Does this standard give enough detail to cost your services appropriately?
Yes No
5.CM16: Sexual health services. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
6.CM16: Have you implemented this standard yet?
Yes No
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7.CM16: Does this standard give enough detail to cost your services appropriately?
(irrespective of whether you have implemented it)
Yes No
8.CM17: Dental services. Please indicate how closely you feel this standard meets
the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
9.CM17: Have you implemented this standard yet?
Yes No
10.CM17: Does this standard give enough detail to cost your services appropriately?
(irrespective of whether you have implemented it)
Yes No
11.CM19: Wheelchair services. Please indicate how closely you feel this standard
meets the following objectives
It's practical to use
The aims are achievable
It can be fully implemented
It delivers transformative change
12.CM19: Have you implemented this standard yet?
Yes No
13.CM19: Does this standard give enough detail to cost your staff appropriately?
(irrespective of whether you have implemented it)
Yes No
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14.CM19: Do you believe you have patient-level information about the wheelchair
equipment in your organisation to use for costing?
Yes No
15.CM19: Does this standard give enough detail to cost the wheelchair equipment
appropriately? (irrespective of whether you have implemented it)
Yes No
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General Comments
1.If you have any further comments about any aspect of the Tranche 1
documentation for the Approved Costing Guidance please let us know here