Background
Salford Royal NHS Foundation Trust uses the National Benchmarker on a regular basis. Each month it examines activity in a particular specialty treatment area. Claire Oates, service reporting accountant at the trust, says: 'We have been using it to look at top ten specialty areas and healthcare resource groups (HRGs), picking one high revenue and high activity area each month to focus on. Discussion between finance and the relevant service manager and coder can either explain outliers or highlight areas for improvement. Results are then reported back to the Trust's Management Information Sub Group.'
Benefits
'It's a huge help both internally and with commissioners. It enables us to pre-empt and investigate potential funder questions and improve how we are managing activity and information internally,' says Oates.
'It gets people to sit up and take notice. The graphs and other reports are powerful ways of getting a range of professionals - service managers, healthcare staff, coders etc - around the table and focusing dialogue. It also adds weight to discussions that we are having with clinicians.'
Oates also emphasises how it helps improve understanding of data recording and coding: 'One of the good things about it is that it brings different professions together in the same room. It can demonstrate and enhance understanding of how Payment by Results income is generated - from the patient notes right through the tariff.'
Examples
'We find things each month which enable us to improve information or which confirm improvements we've already put in place. For example, we were getting a lot of unspecified diagnosis codes recorded for gastroenterology patients and it was down to the way that information was being recorded on the electronic patient records. We were able to take that back to the clinicians, the nurses and the management and other people that worked in the department.'
'Some of the indicators are particularly useful in adding weight to discussions that we are already having with clinicians. For example, indicators can show evidence of high first to follow up ratios, or higher than expected activity in consultant led clinics instead of nurse led clinics.'
Looking ahead
'We're now moving into the phase where we are revisiting the areas we have looked at in the last year to look at the impact of any changes we have made. I'd also want to look at the potential for making up a bespoke scorecard, mixing and matching other indicators together and look at them as a whole.'