The audit was completed using the Audit Commission's outpatient audit methodology on a sample of 150 outpatient appointments from three different areas of activity at the Trust.
The data testing covered 150 records of outpatient attendances which were selected from three treatment functions. Two of these were reviewed in previous audits to enable the Trust and commissioners to identify improvement or otherwise in the testing results. The other area was selected by local agreement between the Trust and host PCT, supported using the Audit Commission's national benchmarking analysis.
The error rates were calculated based on the audit results for the data items: outpatient attendance; attendance type and treatment function. The financial impact of these errors was calculated by applying the national tariff for outpatient attendances (per DH) to the pre- and post-audit data to determine the financial impact of the changes.
| Area Audited |
Attendance
errors (%) |
First / F-up
errors (%)
|
Treatment
function
errors (%) |
Total
errors (%) |
Errors affecting
payment (%) |
Net monetary
change (%) |
| - | - | - | - | - | - | - |
| - | - | - | - | - | - | - |
| - | - | - | - | - | - | - |
* Sample too small to produce meaningful rate
- Not audited
Due to the targeted nature of these audits and the small sample of activity audited it is not recommended that these results be extrapolated further than the actual sample audited. However, they do provide information that will help both commissioners and providers decide if the controls over the accuracy of their activity data are adequate, and highlights areas of concern that they may wish to investigate further.
Our analysis of the data from the audits suggest there are a number of issues which contribute to the errors including:
- quality of information available at the time of data entry;
- poor policy and procedures;
- systems not being in place to capture outpatient procedures;
- limited clinician involvement; and
- data definitions issues for outpatients.