The National Duplicate Registration Initiative (NDRI), first undertaken in 1999, uses leading edge data matching techniques to review general practitioners' (GPs) patient lists to identify inaccuracies in the data that distort both the wider resource allocation within the NHS, and specifically the payments made to GP practices. By tackling these inaccuracies the initiative also enables patients' medical records to be passed to their new GP in cases where previously the system has been unable to link the patient's former and current GP registrations.
Under the new General Medical Service contract the global sum element, which accounts for approximately half of practices income, is based on a practice's population. In addition to global sum payments, which totalled almost £3 billion for England and Wales in 2004/05, there are a number of other payments made under this contractual arrangement that are affected by practice population.
In light of this new contract, and the linked Department of Health commitment to cleansing patient list data, the Audit Commission has undertaken a second NDRI exercise at all Primary Care Trusts (PCTs) and Local Health Boards (LHBs) in England and Wales as part of the statutory audit of the 2003/04 accounts.
Background
The patient list data for all PCTs and LHBs is maintained on 87 National Health Applications and Infrastructure Services (NHAIS) systems. This data, 56 million patient records, was extracted in March 2004 and cross matched between systems to identify possible inaccuracies in the lists that were distorting resource allocations. It was also cross matched to other data sources to identify additional data anomalies.
The results, 1.5 million matches were fed back to the 87 National Health Applications and Infrastructure Services (NHAIS) sites who manage the patient list data for all PCTs and LHBs on 3 June 2004. Over the next 18 months these sites reviewed these matches and, where appropriate, updated their NHAIS system.
National Fraud Initiative (NFI)
The National Fraud Initiative helps detect fraudulent and erroneous payments from the public purse. The NFI began in 1996, and now runs every two years, enabling participants across the UK from local government, central government and the NHS to identify fraud and error running into several million pounds.