By definition: Improving data definitions and their use by the NHS
The Audit Commission’s Payment by Results (PbR) data assurance framework reviews the quality of data that underpins payment for activity within the NHS in England. It is clear from the work that we, and others, carry out that there are issues that cause disputes within and between NHS organisations around key data definitions.
The Audit Commission has published ‘By definition: Improving data definitions and their use by the NHS’, following work undertaken in collaboration with the Department of Health, the Health and Social Care Information Centre and NHS Connecting for Health.
The briefing highlights that differences in the recording of details for a patient who stays in hospital for less than 24 hours are a major cause of dispute between NHS commissioners and providers. We have found that the same treatment may be recorded as an inpatient service at one hospital, or as an outpatient at another. This simple variation can significantly increase charges, even multiplying them five times or more. Routine short-stay treatments cost the health service £6.8 billion a year so discrepancies in contract values can vary by millions.
We reviewed the existing guidance around data definitions in conjunction with the Department of Health, the Information Centre and Connecting for Health, which led to improvements in key pieces of guidance. This updated guidance is included in the briefing.
These issues with data definitions means that the Payment by Results tariff is sometimes based on data that fails to represent the services delivered. This is symptomatic of a wider problem of the need for NHS national data sets to change to take account of the way care is now being delivered in outpatient settings or outside hospitals altogether. The briefing makes a number of recommendations to resolve these issues.
By definition: Improving data definitions and their use by the NHS