Vinidh Paleri MS FRCS (ORL-HNS), consultant surgeon and honorary senior lecturer (otolaryngology-head and neck surgery)
Background
Consultant surgeon Vinidh Paleri uses the National Benchmarker as a check on the picture that coding and data measures in his ENT (ear nose and throat) specialty are presenting.
Benefits
Paleri observes: 'Clinicians need an insight into Payment by Results (PbR) and how it affects us. The National Benchmarker is a good way of getting an insight into what is going on with the coding and the data measures in your trust. If the trust or the specialty is out of line, it is incumbent upon the clinician to meet up with the coding department and look into the issues.'
Examples
Paleri stresses the importance of clinicians and coding departments having a close working relationship: 'At our hospital we have looked at the different elements that contribute to comorbidity grading and made that an integral part of the clerking system for the junior doctors. When the coders go back and try to assess comorbidity it is there right in front of them, making it easy to assign the right grading. If you miss out on comorbidity you miss out on revenue and that is not in anybody's best interests.'
'For example, in ENT we do a procedure called total laryngectomy to remove cancers of the voice box, the larynx. Like many major operations, it typically involves a number of distinct and complex procedures that need to be counted in their own right. PbR will only pay for all of these if the different components of the operation are properly documented by the coders and then grouped under healthcare resource group (HRG) 4. Erroneous grading of comorbidity can cost over £7,500 for a major procedure like a total laryngectomy '.
Verdict
'When clinicians take responsibility in the coding process, the outcome and coding accuracy increases. Medicine is changing all the time and, with the advent of HRG4, working together is even more important. You must have a basic knowledge of PbR and HRG4. Once you have the background information then the National Benchmarker is a doddle to navigate. The illustrations and graphs are highly pertinent. The National Benchmarker is a useful tool for clinicians as well as managers and provides an excellent way of identifying anomalies and issues for attention. It is a fantastic resource to log on to and check how your trust or specialty compares with others.'