NHS reference costs

Reference costs are the average unit cost to the NHS of providing secondary healthcare to NHS patients.

DHSC has collected reference costs from NHS providers for every financial year since 1997.

Reference costs are used to set prices for NHS-funded services in England. They also support our commitment to data transparency for the benefit of patients and the public.

Monitor is now accountable for the reference costs collection, with the department continuing to collect reference costs on its behalf. Monitor’s strategy for costing and cost collection to inform price setting is set out in their Approve Costing Guidance.

Published reference costs

The data collected in reference costs is presented in 3 ways:

  • national schedules of reference costs - these show the national average unit costs derived from the average unit costs of NHS provider
  • reference costs index - a measure of the relative efficiency of NHS providers
  • database of source data - publishing the data submitted by NHS providers gives a valuable source of information for benchmarking of costs and other more detailed analysis (only source data from 2008 to 2009 is currently available)

Reference costs from 1998 to 2009 are available on the National Archives.

  1. NHS reference costs 2015 to 2016
  2. NHS reference costs 2014 to 2015
  3. NHS reference costs 2013 to 2014
  4. NHS reference costs 2012 to 2013
  5. NHS reference costs: financial year 2011 to 2012
  6. 2010-11 reference costs publication
  7. NHS reference costs 2009-2010
  8. NHS reference costs 2009-2010  appendix: DBRC organisation-specific reference cost data

Reference costs collection guidance

The submission of reference costs by NHS providers is supported by detailed guidance published each year by the department. This guidance has been part of Monitor’s ‘Approved Costing Guidance’ since 2013.

Published 23 January 2014
Last updated 15 December 2016 + show all updates
  1. Added NHS reference costs 2015 to 2016.
  2. Added NHS reference costs 2014 to 2015
  3. First published.