By Vivienne Russell
27 August 2009
The coding scheme that underpins the NHS’s Payment by Results system is still shot through with errors, the Audit Commission has found.
In its second annual audit of PbR data, published on August 27, the Audit Commission found that 12% of the clinical codes for diagnoses and procedures were incorrect, an improvement on last year’s figure of 16.5%.
The errors affect the accuracy of payments received for NHS treatment. The commission found that 8% of payments were wrong. This was also an improvement on last year’s average of 9.4%.
There was also considerable variation between trusts, with error rates of 1% at some trusts and 40% at others.
These errors meant that overcharging and undercharging totalled £2.6m. But the commission again concluded that the net financial impact was negligible, at just 0.1%.
Andy McKeon, the Audit Commission’s managing director for health, told Public Finance there were ‘still too many errors’.
‘We’re happy that there’s been a little bit of improvement, that’s good news. We still think there’s more to go.’
He added that a new, more refined version PbR, introduced this year, included even more coding categories, which made precise coding more important.
‘The payments system is now more sophisticated and more sensitive to data quality accuracy, which means we are likely to see an increase in error rates in 2009/10,’ he said.
‘Improving the quality of the data, and in some cases the quality of medical records too, is important if the NHS is to improve the quality of its care and its efficiency as well as accurately report its performance. Our report shows how improvements can be made.’
The Audit Commission also highlighted poor quality of record keeping more generally. About 80% of PbR audit report noted problems with the quality of medical records and some medical records were judged ‘unsafe to audit’, meaning there was no evidence on record that anything had been done to the patient.
The Royal College of Physicians has produced a report for the Audit Commission making a series of recommendation on how medical records can be improved.
Professor Iain Carpenter, associate director, records standards at the RCP, said: ‘Implementing the Academy of Medical Royal Colleges’ Record Keeping Standards can improve medical records and the accurate retrieval of important clinical data.
‘This report also shows that using the standards would make clinical coding more efficient and accurate, reducing financial errors in the reimbursement of hospital activity.’
27 August 2009
The coding scheme that underpins the NHS’s Payment by Results system is still shot through with errors, the Audit Commission has found.
In its second annual audit of PbR data, published on August 27, the Audit Commission found that 12% of the clinical codes for diagnoses and procedures were incorrect, an improvement on last year’s figure of 16.5%.
The errors affect the accuracy of payments received for NHS treatment. The commission found that 8% of payments were wrong. This was also an improvement on last year’s average of 9.4%.
There was also considerable variation between trusts, with error rates of 1% at some trusts and 40% at others.
These errors meant that overcharging and undercharging totalled £2.6m. But the commission again concluded that the net financial impact was negligible, at just 0.1%.
Andy McKeon, the Audit Commission’s managing director for health, told Public Finance there were ‘still too many errors’.
‘We’re happy that there’s been a little bit of improvement, that’s good news. We still think there’s more to go.’
He added that a new, more refined version PbR, introduced this year, included even more coding categories, which made precise coding more important.
‘The payments system is now more sophisticated and more sensitive to data quality accuracy, which means we are likely to see an increase in error rates in 2009/10,’ he said.
‘Improving the quality of the data, and in some cases the quality of medical records too, is important if the NHS is to improve the quality of its care and its efficiency as well as accurately report its performance. Our report shows how improvements can be made.’
The Audit Commission also highlighted poor quality of record keeping more generally. About 80% of PbR audit report noted problems with the quality of medical records and some medical records were judged ‘unsafe to audit’, meaning there was no evidence on record that anything had been done to the patient.
The Royal College of Physicians has produced a report for the Audit Commission making a series of recommendation on how medical records can be improved.
Professor Iain Carpenter, associate director, records standards at the RCP, said: ‘Implementing the Academy of Medical Royal Colleges’ Record Keeping Standards can improve medical records and the accurate retrieval of important clinical data.
‘This report also shows that using the standards would make clinical coding more efficient and accurate, reducing financial errors in the reimbursement of hospital activity.’
