Reference costs

Reference costs are the average unit cost to the NHS of providing defined services to NHS patients in England in a given financial year. They show how NHS providers spend money to provide healthcare to patients.

NHS providers submit reference costs annually. The costs are used to inform a number of work streams including the Model Hospital, the Getting It Right First Time (GIRFT) programme and national tariff prices. They are a key source of information about the cost of NHS services.

2017/18 reference cost data

We have produced a short document of highlights and analysis and a guide to using the reference cost data.

The reference cost data is then presented in four ways: 

  • the national schedules of reference costs 
  • the reference cost index 
  • the reconciliation statement 
  • a database of source data 

Introduction and data spreadsheets

Reference costs 2017/18: highlights, analysis and introduction to the data PDF, 270.2 KB

This document shows highlights, analysis and an introduction to the 2017/18 data.

National schedule of reference costs XLSX, 3.7 MB

The main schedule, showing data for the whole range of services provided by provider, including admitted patient care on a finished consultant episode (FCE) basis.

The reference cost index (RCI) XLSX, 159.1 KB

The reference cost index (RCI) is a measure of the relative cost difference between NHS providers.

Reference cost index (RCI) by department and service code XLSX, 9.2 MB

A more granular view of the reference cost index (RCI) by department and service code.

The reconciliation statement XLSX, 405.4 KB

Shows the adjustments made to get from provider audited financial accounts to their total reference costs.

2017/18 reference cost data files

Reference cost data is held in large csv files and should be accessed using MS Access or other database software.

User guide: reference costs 2017/18 PDF, 683.8 KB

This document gives advice on how to use the data contained in the three zip files below.

Organisation level source data part 1 ZIP, 33.4 MB

Unadjusted data as submitted by NHS providers in England.

Organisation level source data part 2 ZIP, 50.5 MB

Market forces factor (MFF) adjusted data.

Organisation level source data part 3 ZIP, 140.6 KB

Remaining organisational source level data and reference cost survey responses

2017/18 reference cost collection guidance

The cost collection guidance for 2017/18 reference costs is available as part of the Approved Costing Guidance. The Approved Costing Guidance is updated each year.

Archived reference costs

2016/17 reference costs

Previous years' reference costs

Help and support

If you have any queries on this project or costing in general please email to

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