DHSC guidance recommended querying outliers with providers, however there was no clear guidance provided between a cost being inefficient or an outlier. Peopletoo recommended the approach set out below as a method to identifying potential outliers in the absence of clear guidance.
Using an outlier tool Peopletoo engaged with providers where anomalies were identified and clarify outliers at line level.
Validation was completed across 3 cycles to attempt to resolve any concerns regarding the data supplied. Where Peopletoo were unable to obtain a response from a provider and that provider was considerably outside the ranges of data submitted, these submissions were flagged as outliers. The majority of data validation was done by phone as it was the easiest and most efficient method of contacting providers in the timescales available.
Evidence to support the data validation was not sought as part of this process. There was ambiguity on this in the guidance and whilst this would have provided more confidence in the data collated, the percentage returns may have been lower as this would have been far more onerous for providers. There was also insufficient time to evidence the data submitted.
Time constraints have not allowed for due diligence to take place. Scrutiny has been limited as the quality of submissions has been very poor. Clarifications with providers has been incredibly laborious and there was not practical way of scrutinising central overheads. The median calculation method produced results that do not reliably reflect market costs.