PHB Data Analysis 2023/24
NHS Digital recently published the PHB statistics for the final quarter of 2023/24. Here are our observations for the third year running.
PHBs increase again...
The NHS England commentary focusses on the ‘year-to-date’ measure of PHBs (2024: 188,489), which is a commendable 9% increase on the comparable number for last year.
Whilst PPL continue to believe that the ‘active at quarter-end’ measure more accurately reflects the underlying position and trends (as it effectively excludes most one-off or wheelchair PHBs), that figure at the end of March 2024 (90,409) is also 9% up on the previous year, which is impressive:
Conflicting trends in direct payments...
On one hand, over the last three years, the number of direct payments PHBs has steadily increased. On the other hand, direct payments as a proportion of all PHBs have steadily fallen over the same time frame, from 22% to 15%.
Understanding the movements...
In 2024, there were 188,489 PHBs, which is a 9% year-on-year increase. We have mapped the movements that underpin this as follows:
- Adult PHBs rose by 6%, whereas children's PHBs rose by 37%.
- The increase in children's PHBs was driven by EHCs (increase of >500%) and learning disabilities / mental health (both increasing by >50%).
- Within both adults and children's, the number of CHC PHBs fell slightly year-on-year.
- Within both adults and children's, the number of wheelchair PHBs did not change materially in the year.
- Within both adults and children's, the number of ‘other’ PHBs increased materially (c.20%) year-on-year. We repeat our previous suggestion that more analysis is needed on this category.
The gap between top and bottom is significant...
There is a significant gap between the best-performing and worst-performing ICBs in terms of PHBs. The top 3 ICBs account for 22% of all PHBs, and the bottom 3 ICBs account for just 1% of all PHBs.
The gap is even more pronounced when looking at PHBs paid as direct payments, where the top 3 ICBs account for 32% of all direct payments, and the bottom 3 ICBs have just 202 direct payments between them.
Fastest risers...
One feature of the analysis that we have done each year is a marked lack of consistency in relation to the ‘best’ and ‘worst’ performing ICBs (i.e. the stats tend to jump around a lot). This year we are highlighting those ICBs that have made the highest year-on-year increase as follows:
Keep up the good work...
Despite the complexities of the data, PHBs are clearly continuing to grow. As ever, we applaud all those involved, from the top right down to the individual nurses at the coalface. One PHB won't materially shift the statistical analysis, but it might make the world of difference to an individual and their family.
What do you think?
If you would like to informally discuss any of our analysis, or understand how PPL can help you deliver PHBs, please get in touch.