Improving coding, costing and commissioning [NHS] – Audit Commission – 22 September 2011

Posted on September 22, 2011. Filed under: Health Economics, Medical Records | Tags: , |

Improving coding, costing and commissioning [NHS] – Audit Commission – 22 September 2011

Annual report on the Payment by Results data assurance programme 2010/11Released  22 September 2011

In our annual report looking at the Payment by Results (PbR) data assurance programme, ‘Improving coding, costing and commissioning: Annual report on the Payment by Results data assurance programme 2010/11’, we say that the data used to inform the current PbR tariff in the last financial year was generally good, but the NHS needs to improve the quality of its data if the government is to expand its PbR system.

The data for ‘non-tariff’ areas such as community services and chemotherapy was often of poor quality, and it is these areas that will be brought under the PbR umbrella under the government’s plans. This data is also currently used to inform local contracts.

Extending the PbR tariff system is a key government policy. Under their plans, most or all of the £51 billion spent on acute hospital activity, as well as wider community and health services, will be subject to a PbR tariff. Currently it covers £26 billion of acute services. The report summarises the findings of the Commission’s annual audit of data used to underpin PbR payments. This year the Commission looked at reference costs that are used to set the tariff, and also conducted the first major review of independent sector hospitals as part of its clinical coding programme.

An important finding from our research is that there are simple solutions available to trusts wanting to improve their data. Greater use of basic checks by trusts would lead to improved data quality. These include checking submissions against other data sources, and benchmarking unit costs against those of other providers. Better senior leadership within organisations and greater clinical involvement are also needed.

Our report finds trusts that followed recommendations from their auditors saw the quality of their data improve substantially. A checklist covering ten key areas that senior hospital managers can use to improve reference cost data quality is included in the report. The Commission’s award-winning National Benchmarker can also be used to check for discrepancies in data.”

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