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Article
Publication date: 12 June 2009

Edward Britton, Charles Chambers and Alexander Ashmore

Coding clinical work should allow accurate and precise methods of assessing individual or department activity. The NHS financial reforms have increased correct diagnostic coding…

Abstract

Purpose

Coding clinical work should allow accurate and precise methods of assessing individual or department activity. The NHS financial reforms have increased correct diagnostic coding importance by introducing “payment by results” so that funding is directly linked to patient activity. The aim of this study is to assess the accuracy of procedure codes (OPCS 4.4), and its effect on Healthcare Resource Group tariff codes that directly affect revenue.

Design/methodology/approach

A total of ten procedures from ten consultants were randomly selected over one month. Each consultant coded his or her own procedures. From these codes, Healthcare Resource Group tariff codes were assigned to each patient. These were compared with procedure and Healthcare Resource Group tariff codes generated by coding department staff.

Findings

Of 100 procedures, four were un‐coded by coding department staff. There was concordance in 35 per cent of cases. Coders only gave one code for each procedure, whereas 35 per cent of procedures coded by consultants were assigned multiple codes. This resulted in 27 per cent of cases generating a different Healthcare Resource Group tariff code. Of the cases, five resulted in a difference of £4,000 or more; however, the overall difference was a £3,367 revenue loss if coder's codes were used.

Research limitations/implications

Study numbers were limited to 100 with five cases showing excessive financial gain or loss significantly influencing the overall result.

Practical implications

Present procedure coding practice is inaccurate and results in Healthcare Resource Group tariff codes that do not accurately represent clinical activity and productivity. Under payment by results, this can result in a significant revenue loss and possibly ultimately future referrals. Therefore, coding practice needs to be improved as a matter of urgency. Arguably, this could be achieved by closer communication between coders and clinicians.

Originality/value

The paper identifies a flaw in the way clinical activity and productivity is assessed at present. This is fundamental to the process on which “payment by results” is based, and therefore must be addressed if trusts are to be financially successful.

Details

International Journal of Health Care Quality Assurance, vol. 22 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Book part
Publication date: 13 August 2020

John Stone, David Ashmore, Crystal Legacy and Carey Curtis

New economies based on emerging technologies for shared mobility and autonomous vehicles will shape future urban transport systems, but their potential impacts are uncertain…

Abstract

New economies based on emerging technologies for shared mobility and autonomous vehicles will shape future urban transport systems, but their potential impacts are uncertain. Internationally, government agencies face difficult challenges to effectively plan and regulate the deployment of these technologies for the common good, whilst simultaneously encouraging innovation. Being both a facilitator and an umpire is not an easy task. This chapter draws on a series of interviews with public and private-sector actors in urban transport in Australia. Unsurprisingly, all private-sector respondents had significant concerns for the sustainability of their business in the emerging mobility markets, but it was generally acknowledged that without government support and partnership, a lack of structure and clarity could lead to natural monopolies with negative consequences for competition and the public good. Strong and clear government regulation is seen to be necessary to allow the sector to reach its maximum potential and have positive ramifications for both the public and the private good – outcome not always seen as compatible. Public-sector interviewees generally recognised that much of the necessary innovation was being shaped by the market, and that there had been a considerable loss of skills over decades from the state because of neo-liberal policies. So, some doubted the ability of the state to shape developments using currently available planning and public policy methods and feared that it would be difficult to regulate emergent markets to prevent monopolies emerging. On the other hand, some argued that many firms are looking to government for frameworks in which businesses can operate successfully by setting conditions in which risks could be managed. This chapter discusses these issues, seeking to guide research agendas and to foster further debate. The evidence gained from these in-depth interviews helps focus attention on which forms of regulation might be required by industry. It also raises questions about the capacity of government agencies to effectively manage these complex transitions.

Details

Shaping Smart Mobility Futures: Governance and Policy Instruments in times of Sustainability Transitions
Type: Book
ISBN: 978-1-83982-651-1

Keywords

Article
Publication date: 25 December 2023

Russell Ashmore

The purpose of this paper is to report on the use and content of written guidance produced by mental health services in England and Wales describing hospital leave for informally…

Abstract

Purpose

The purpose of this paper is to report on the use and content of written guidance produced by mental health services in England and Wales describing hospital leave for informally admitted patients.

Design/methodology/approach

Guidance on leave was requested from National Health Service (NHS) mental health trusts in England and health boards in Wales (n = 61) using a Freedom of Information submission. Data were analysed using content analysis.

Findings

In total, 32 organisations had a leave policy for informal patients. Policies varied considerably in content and quality. The content of policies was not supported by research evidence. Organisations appeared to have developed their policies by either adapting or copying the guidance on section 17 leave outlined in the Mental Health Act Codes of Practice for England and Wales (Department of Health, 2016; Welsh Government, 2016). Definitions of important terms, for example, leave and hospital premises, were either absent or poorly defined. Finally, some organisations appeared to be operating pseudo-legal coercive contracts to prevent informal patients from leaving hospital wards.

Research limitations/implications

Research should be undertaken to explore the impact of local policies on the informal patient’s right to life and liberty.

Practical implications

All NHS organisations need to develop an evidence-based policy to facilitate the informal patient’s right to take leave. A set of national standards that organisations are required to comply with would help to standardise the content of leave policies.

Originality/value

To the best of the author’s knowledge, this is the first study to examine the use and content of local policies describing how informal patients can take leave from hospital.

Details

Mental Health Review Journal, vol. 29 no. 1
Type: Research Article
ISSN: 1361-9322

Keywords

Content available
Book part
Publication date: 13 August 2020

Abstract

Details

Shaping Smart Mobility Futures: Governance and Policy Instruments in times of Sustainability Transitions
Type: Book
ISBN: 978-1-83982-651-1

Book part
Publication date: 13 August 2020

Sam McLeod, Carey Curtis and John Stone

Modelling has been a mainstay of conventional planning support tools (PSTs) since the 1960s and is instrumental in transport and land use planning decision-making. Numerous…

Abstract

Modelling has been a mainstay of conventional planning support tools (PSTs) since the 1960s and is instrumental in transport and land use planning decision-making. Numerous studies have been conducted to model the potential impacts of emerging vehicle automation and sharing technologies. A systematic review of recent modelling studies of autonomous and shared vehicles in the research literature examines the extent of their contribution to ‘smart’ mobility knowledge. The findings suggest a limited knowledge base from which to support future planning. PSTs that can offer more pluralistic, discursive, and transparent methods in order to understand and proactively shape a transition to a planned urban future are also needed.

Details

Shaping Smart Mobility Futures: Governance and Policy Instruments in times of Sustainability Transitions
Type: Book
ISBN: 978-1-83982-651-1

Keywords

Book part
Publication date: 13 August 2020

Ioanna Moscholidou

There are different narratives surrounding smart mobility, which can sometimes even appear as opposing (Lyons, 2018). Its fiercest proponents are promising versions of a…

Abstract

There are different narratives surrounding smart mobility, which can sometimes even appear as opposing (Lyons, 2018). Its fiercest proponents are promising versions of a revolutionised future, where users have on-demand access to multiple mobility options and are freed from car ownership, while transport systems become carbon neutral and congestion is a problem of a bygone age (Sherman, 2019). At the same time, the plausibility of such visions of the future has been questioned, with critics warning against the potentially negative impacts of the widespread adoption of privately provided services and stressing the need for state intervention to avoid exacerbating ‘classic’ transport issues such as congestion and unequal access to services, as well as creating new challenges such as uncontrolled market monopolies (Docherty, Marsden, & Anable, 2018). Drawing from these narratives, this chapter explores how officials from English transport authorities see state intervention evolve in the future, and what accountability arrangements are necessary to achieve the level of steering they envisage. Based on interviews with local authority officials, this chapter shows that the officials’ views generally align more closely with the narrative of providers than with that of critics. Although different local authorities envisage varying levels of control and steering of smart mobility, they all expect new services to improve the local transport provision. This chapter also discusses the barriers local authorities face in shaping local accountability arrangements.

Details

Shaping Smart Mobility Futures: Governance and Policy Instruments in times of Sustainability Transitions
Type: Book
ISBN: 978-1-83982-651-1

Keywords

Article
Publication date: 1 September 2014

Charles Parrack, Bill Flinn and Megan Passey

Self-recovery in post-disaster shelter is not the exception but the norm. Following earthquake, flood or storm, the majority of affected families will inevitably rebuild their…

69

Abstract

Self-recovery in post-disaster shelter is not the exception but the norm. Following earthquake, flood or storm, the majority of affected families will inevitably rebuild their homes themselves, using their own resources, but there is little support from the international community to encourage good safe building practice. While the communication of key messages about safer building has been carried out effectively in development contexts, it rarely forms a major part of humanitarian response programming. If the humanitarian shelter sector is committed to the principles of Disaster Risk Reduction (DRR), more can be done to support the process of safer reconstruction among self-rebuilders. This paper argues the case for the humanitarian community to link post-disaster shelter programming with the more developmental approach of communicating building safety to a much wider audience than just the most vulnerable beneficiaries. It proposes the shelter sector and the donor community direct more resources towards support for this process, which would augment the effectiveness and impact of a shelter response.

Details

Open House International, vol. 39 no. 3
Type: Research Article
ISSN: 0168-2601

Keywords

Book part
Publication date: 13 August 2020

Claus Hedegaard Sørensen and Alexander Paulsson

In this chapter, the authors will summarise the entire book and look ahead. The aim of this book has been to take the calls for governance of smart mobility one step further by…

Abstract

In this chapter, the authors will summarise the entire book and look ahead. The aim of this book has been to take the calls for governance of smart mobility one step further by analysing and discussing current and future policy instruments to govern smart mobility. The task has been carried out by discussing the why, how and what of policy instruments. So far, the policy instruments governing smart mobility to a large extent are focussed on understanding this new field of mobility, establishing relations and roles between companies and authorities, and making the field governable. What is lacking in this equation are policy instruments that establish the population as citizens with rights, voices and roles. In order to align the smart mobility transition and the transition towards a sustainable society, the authors consider the development of deliberative citizen participation an important initiative and the authors suggest it as an important field for future research.

Details

Shaping Smart Mobility Futures: Governance and Policy Instruments in times of Sustainability Transitions
Type: Book
ISBN: 978-1-83982-651-1

Keywords

Book part
Publication date: 22 May 2017

Justin Olmanson, Zoe Falls and Guieswende Rouamba

For more than a century, state and federal governments and organizations have used different measures to determine if students and groups of students have achieved in a particular…

Abstract

For more than a century, state and federal governments and organizations have used different measures to determine if students and groups of students have achieved in a particular subject or grade level. While the construct of achievement is applied irrespective of student differences, this equal application turns out to be anything but equitable. In this chapter, we work to understand the way achievement plays out for Black students by deconstructing how the word achievement works. In doing so, we track the history of education, testing, and curriculum as it has been applied to Black youth and youth of color.

Details

African American Children in Early Childhood Education
Type: Book
ISBN: 978-1-78714-258-9

Keywords

Article
Publication date: 25 April 2018

Caroline Hood and Peter Reid

The purpose of this paper is to examine issues associated with user engagement on social media with local history in the North East of Scotland and to focus on a case study of the…

2236

Abstract

Purpose

The purpose of this paper is to examine issues associated with user engagement on social media with local history in the North East of Scotland and to focus on a case study of the Buckie and District Fishing Heritage Society, a small but very successful and professionally-run community-based local heritage organisation.

Design/methodology/approach

A qualitative approach using photo elicitation on social media was deployed in conjunction with analysis of the user interactions and the reach insights provided by Facebook to the page manager. Additionally, a focus group was used.

Findings

The research, although focussed on an individual case study, offers significant lessons which are more widely applicable in the local history and cultural heritage social media domain. Key aspects include user engagement and how digital storytelling can assist in the documentation of local communities ultimately contributing to local history research and the broader cultural memory. The significance of the image and the photo elicitation methodology is also explored.

Social implications

The research demonstrates new opportunities for engaging users and displaying historical content that can be successfully exploited by community heritage organisations. These are themes which will be developed within the paper. The research also demonstrates the value of photo elicitation in both historical and wider information science fields as a means of obtaining in-depth quality engagement and interaction with users and communities.

Originality/value

The research explored the underutilised method of photo elicitation in a local history context with a community possessed of a strong sense of local identity. In addition to exploring the benefits of this method, it presents transferable lessons for how small, community-based history and heritage organisation can engage effectively with their audience.

Details

Journal of Documentation, vol. 74 no. 4
Type: Research Article
ISSN: 0022-0418

Keywords

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