UK - The Audit Commission has published its report to the Department of Health on the proposed Payment by Results (PbR) data assurance framework for the National Health Service (NHS)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 27 March 2007

89

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Citation

(2007), "UK - The Audit Commission has published its report to the Department of Health on the proposed Payment by Results (PbR) data assurance framework for the National Health Service (NHS)", International Journal of Health Care Quality Assurance, Vol. 20 No. 2. https://doi.org/10.1108/ijhcqa.2007.06220bab.004

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Emerald Group Publishing Limited

Copyright © 2007, Emerald Group Publishing Limited


UK - The Audit Commission has published its report to the Department of Health on the proposed Payment by Results (PbR) data assurance framework for the National Health Service (NHS)

Europe, Middle East and Africa

UK

The Audit Commission has published its report to the Department of Health on the proposed Payment by Results (PbR) data assurance framework for the National Health Service (NHS)

Keywords: Healthcare information, Quality assurance, Clinical governance

The Payment by Results Assurance Framework report includes results of PbR data assurance pilot testing in England and recommendations for the Department of Health.

The new comprehensive national programme of clinical coding audits in the NHS, recommended in the report, will be undertaken by the Commission and affects all primary care trusts (PCTs), NHS trusts and NHS foundation trusts.

PbR is the new system of payments for treatments in the NHS. A gradual roll-out of the system across the NHS began over three years ago and, in January 2006, the Department of Health asked the Audit Commission to develop and test aspects of a proposed assurance framework for PbR for England.

Steve Bundred, Chief Executive of the Audit Commission, said:

Accuracy of payments under Payment by Results depends upon high-quality data. The pilots we undertook for the Department of Health earlier in the year showed weaknesses in the underpinning data, although these were not so significant as to destabilize the system. We are pleased that the Department has agreed to the proposed independent national clinical coding audit programme to help assure and improve the quality of the data on which payments are determined. The programme will complement what individual PCTs need to do themselves. It is not a substitute for local action.

The PbR data assurance framework will come into effect this year (2007). It has two elements:

  1. 1.

    National analysis of data – this will identify variations in activity in individual trusts which might be the result of differences in approach to recording basic data, rather than to differences in clinical practice. The results of this will be regularly reported to PCTs and NHS trusts.

  2. 2.

    Clinical coding audit of each NHS trust and NHS foundation trust – this will be informed by the national analysis of data. The methodology will be refined in light of the PbR data assurance pilot work.

The audit programme is to be developed to address new areas covered by PbR (outpatients and critical care) and is expected also to apply to the independent (private and voluntary) sector in due course.

The Audit Commission will provide details of lessons emerging from the assurance framework on a regular basis. The first of these briefing notes, based on the findings from the pilots, is being issued to the NHS today. PCTs will also receive a guide on what local action must be taken to assure accurate payments under PbR.

The full findings of the pilots are in the report Payment by Results Assurance Framework, available at www.audit-commission.gov.uk/health The report and the proposed audit programme were endorsed by an external reference group which included representatives from the NHS and relevant national bodies.

The following comments were made regarding the new data assurance framework.

Health Minister, Lord Warner, said:

The new programme of audit will improve the quality of patient-level clinical coding. Not only will it help ensure more accurate payments – which is good news for both commissioners and providers – it will also support improved clinical governance, research and offer a sounder foundation for strengthening commissioning arrangements.

Dr Michael Dixon, Chair of the NHS Alliance, said:

Payment by Results is the new currency of NHS commissioning and it is absolutely crucial that it works for PCTs, the new practice based commissioners and their patients. NHS Alliance warmly congratulates the Audit Commission on exposing weaknesses and inaccuracies in the present system and believes it has richly deserved its new role in leading the independent national coding audit programme, which will ensure a level playing field for both commissioners and providers.

Trevor Campbell Davies, Chief Executive of Oxford Radcliffe Hospitals NHS Trust, said:

As a trust chief executive, I welcome the proposed independent clinical coding audit programme. It will be important in reinforcing the confidence of both PCTs and trusts in the fairness and accuracy of the payments being made, as well as helping to improve the quality of data available for management and other purposes.

John McIvor, Chief Executive of Lincolnshire Primary Care Trust, said:

I am delighted that the Department of Health has agreed to the independent national clinical coding audit programme. I believe that this is a critical underpinning to the delivery of Payment by Results. The delivery of the framework by the Audit Commission will ensure that PCTs can have confidence in the information which they receive from acute hospitals. This will allow them to plan and procure health services to meet the needs of local populations in a more effective and appropriate manner.

For further information: www.audit-commission.gov.uk/reports/

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