As the NHS moves towards a population-based approach to service delivery, and healthcare systems shift away from acute care tariff-based payments, it’s crucial that we do not lose our focus on data quality.
A trust-wide understanding of data quality is crucial
The last national audit of clinical coding data highlighted the pressures coding departments are under with deadlines becoming tighter; high vacancy rates and inexperienced staff increasing the risk of error as well as coding system issues. This was found to be having an impact on the accuracy of data capture and it was clear that the NHS needed to continue to improve the quality of data to ensure accurate payments and high standards of care. Significant steps are being made through the Getting it Right First Time (GIRFT) programme with a coding workstream focusing on accuracy of coding and increasing collaboration with clinical teams.
Inaccurate data not only affects a trust’s income but can have a knock-on effect on how services are commissioned, the monitoring of clinical quality and even service redesign, as evidenced in this report by Grant Thornton. A greater focus on the importance of data is crucial to help drive improvement, and trusts must have a good understanding of the causes of poor data recording.
Shifting all the responsibility onto clinical coding teams for accurate clinical coding is a flawed approach. Clinical coding should be the responsibility of everyone within the trust to make sure that the importance of properly and clearly recorded data is understood. Clinicians have an integral part to play as this recent report has highlighted.
Maintaining data quality is vital to highlight where change is needed
The development of payment systems that better support integrated care is an inevitable consequence of meeting the aspirations of the NHS Long Term Plan. Better connected healthcare systems should lead to improved patient outcomes and patient experience.
With integrated care come integrated budgets and the aim of providing a more flexible deployment of resources to meet the health needs of the population rather than paying for tightly defined activities. However, if good clinical coding quality data is no longer the main driver for trust income, then it is vital that health systems continue to recognise its value and keep striving for improved data accuracy.
Data quality is the bedrock of performance management and effective benchmarking as well as predictive modelling that can help trusts to see the impact of certain actions. It is also vital when it comes to helping our healthcare systems plan future capacity requirements in the face of the next pandemic. So, it is not just NHS acute trusts that will be operating in the dark without accurate data. Data is fundamental to population health management, pinpointing where resources will be best placed and now is not the time to reverse the gains that have been made.
Belvin Manoy
Director of Clinical Coding services and Benchmarking, CHKS
Bevin is the Director of Clinical Coding services and Benchmarking for CHKS (part of Healthcare Decisions). Bevin has over 15 years’ experience of working with healthcare organisations on performance management and improvement, data quality, clinical coding and costing. He led the operational delivery of the PbR assurance framework for six years reviewing clinical coding, outpatient data and reference costs. He has written national briefings on clinical coding data quality.
