I read with interest Dr Charles Alessi’s recent article about his consortium’s plans for checking coding of acute activity.
The Audit Commission has delivered a data assurance framework in the NHS for the last four years that already provides some of the ingredients for Dr Alessi’s plans. The payment by results data assurance framework assesses the quality of data that underpin payments.
It has checked the accuracy of clinical coding, healthcare resource group derivation and resulting payments at all acute trusts in England. In 2011/12, we will audit other data such as gender, length of stay and admission and discharge dates, which feed payment by results payments.
The accuracy of clinical coding is improving. We have also concluded there is no evidence of systematic upcoding by acute providers. Nationally, the under-charging or over-charging resulting from the errors we identified was close to zero. Consortia should build on our work.
Dr Alessi’s proposals for more clinical review of activity may well be valid. But this should be integrated locally with the existing national audits, maximising the impact of existing resources.
Andy McKeon, MD, health, Audit Commission