NHS Alliance calls for independent coding

PCTs and hospital trusts should employ independent coders to eliminate concerns over incorrect coding from secondary care, according to the NHS Alliance.

Dr Mike Dixon, chair of the NHS Alliance, said commissioners were concerned about the level of errors in coding and that foundation trusts faced a financial incentive to “code up” activity.

He added: “There’s a massive difference between what’s happening and what’s said to be happening. PCTs and hospital trusts should employ neutral coders.”

He highlighted a pilot study on coding conducted by the Audit Commission earlier this year which found error rates of between 3.5 and 28% with an average coding error rate of 11.9%.

Dr Dixon said it was disheartening when practice-based commissioning (PBC) consortia were working hard to redesign services but the balance sheet appeared unrelated to what they had actually changed.

In his own practice, College Surgery in Cullompton, Devon, the practice reduced its referrals but still ended the year in deficit because charges from the local foundation charge for elective admissions. These increased by £100,000 even though rates were down by 4% and there had been no change in the patient profile.

Dr Dixon said provision of accurate and timely information was an issue for all PCTs who might need to look to the Framework for producing External Support for Commissioners (FESC) to improve the quality of data provided to commissioners.

Last week’s NHS Alliance conference heard further criticism of the Secondary Uses Service from the Alliance PBC lead Dr David Jenner who also called for independent coding.

He told the conference: “The SUS is not designed for individual patient charging and you have got problems when you start using data for purposes in was not designed for. You can’t make a silk purse out of a sow’s ear.”

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