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NHS data accuracy is getting better, but there is still room for improvement

30 August 2012

The Audit Commission has found that the quality of data being used by the health service’s Payment by Results (PbR) system has improved since it reviewed all NHS acute trusts last year.

It has also noted a gradual improvement in clinical coding overall since PbR began.

Payment by Results is the tariff that aims for fair hospital funding. But it relies on accurate data. Published today is Right data, right payment – Annual report on the Payment by Results data assurance programme 2011/12 For the past five years this Audit Commission programme has provided assurance to the NHS on the quality of the data underpinning PbR payments, and reported annually on progress.

Across all NHS trusts, performance on clinical coding has improved since the PbR assurance framework started, with average error rates dropping each year and a narrower range of error.

But individual trust performance varies each year. Many trusts struggle consistently to achieve good levels of accuracy, and some have consistently performed poorly.

The Audit Commission’s MD of Health, Andy McKeon, says:

‘Payment by Results can only ever be as good as the data that underpins it. We have found the overall picture to be one of gradually improving quality and accuracy.

‘But health service providers can still do more to improve data quality. For example, it was disappointing that only a half of trusts had made good progress in implementing previous audit recommendations. ‘

Work carried out in 2011/12 by the Commission’s PbR assurance programme included auditing 33,373 episodes of care, following up previous audit recommendations at individual trusts to see how well they were being delivered; and reviewing primary care trusts’ (PCTs) arrangements to secure quality data.

Andy McKeon adds:

‘Commissioners need to be more robust in seeking assurances on the quality of the data and the steps being taken to improve it. Few PCTs performed well in all aspects of ensuring they used quality data for contracting and payment purposes.

‘This report contains a checklist we have developed to help, and the Audit Commission’s award-winning National Benchmarker can also be used to check for data discrepancies.’

Notes to editors

  1. The report ‘Right data, right payment – Annual report on the Payment by Results data assurance programme 2011/12‘ can be downloaded from the Audit Commission website.
  2. Only four trusts have consistently been in the best performing category each year since the assurance programme started in 2007/08: Cambridge University Hospitals NHS Foundation Trust; Kingston Hospital NHS Trust; Tameside Hospitals NHS Foundation Trust; and Wrightington, Wigan and Leigh NHS Foundation Trust.
  3. 29 trusts were audited in 2010/11 because they had performed consistently poorly. Six of the 29 have improved performance and are now in the best performing category: Barnet And Chase Farm Hospitals NHS Trust; Homerton University Hospital NHS Foundation Trust; Croydon Health Services NHS Trust; Moorfields Eye Hospital NHS Foundation Trust; Royal Surrey County Hospital NHS Foundation Trust; United Lincolnshire Hospitals NHS Trust
  4. But ten of the 29 are still in the worst performing category of trusts: East And North Hertfordshire NHS Trust; Colchester Hospital University NHS Foundation Trust; Guy’s And St Thomas’ NHS Foundation Trust;Heart Of England NHS Foundation Trust; Heatherwood and Wexham Park Hospitals NHS Foundation Trust; King’s College Hospital NHS Foundation Trust; Leeds Teaching Hospitals NHS Trust; The Mid Yorkshire Hospitals NHS Trust; Royal Free London NHS Foundation Trust; and The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust.
  5. The Audit Commission’s assurance programme is continuing in 2012/13. Operational activity is being undertaken by Capita on behalf of the Commission.
  6. The Audit Commission is a public corporation set up in 1983 to protect the public purse. The Commission appoints auditors to councils, NHS bodies (excluding NHS foundation trusts), local police bodies and other local public services in England, and oversees their work. The auditors we currently appoint are either Audit Commission employees (our in-house Audit Practice) or one of the private audit firms. We also help public bodies manage the financial challenges they face by providing authoritative, unbiased, evidence-based analysis and advice.

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