View June's Board Pack - Royal Bournemouth Hospital

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ContentsSummary.............................................................................................................2Introduction...................................................................................................2Summary of overall findings .........................................................................2Audit results..................................................................................................3Key areas for improvements.........................................................................5Recommendations........................................................................................5Next steps.....................................................................................................6Detailed report....................................................................................................7Introduction...................................................................................................7Audit Approach .............................................................................................8Scope of the audit.........................................................................................8Unsafe to Audit (UTA)...................................................................................9Findings ........................................................................................................9Next steps...................................................................................................16Appendix 1 – Action Plan (PCT) .....................................................................18Appendix 2 – Action Plan (Trust)....................................................................19Appendix 3 – Specialty A - General Medicine ...............................................21Appendix 4 – Specialty B - General Medicine ...............................................34Appendix 5 – Chapter - JC Skin......................................................................50Appendix 6 – HRG area EB01Z - Non interventional acquired cardiacconditions 19 years and over .........................................................................67Appendix 7 – Ungrouped original Cardiology results from 2007/08 ...........71Appendix 8 – Error keys..................................................................................72Appendix 9 – Glossary ....................................................................................77Audit Commission Payment by results data assurance framework 1
SummaryIntroduction1 The Payment by Results (PbR) Data Assurance programme (theprogramme) supports the improvement of data quality. Accurate coding datais important as it is the underlying information used, not only for billing bytrusts, but also for information on the health of the local community bycommissioners.2 Since 2007/08, the programme has identified £9 million of incorrectlycoded activity from over £200 million of payments. There have beenimprovements with the accuracy of clinical coding improving from a 16 percent error rate to 11 per cent in 2009/10.3 Under PbR PCTs are charged by trusts according to the HealthcareResource Groups (HRGs) they deliver. The Royal Bournemouth andChristchurch Hospitals NHS Foundation Trust (the Trust) was selected for atargeted audit as the HRG error rates over three years places it in the worstperforming 20 per cent of trusts. We carried out the audit in December 2010using data from 1 April to 30 June 2010.Summary of overall findings4 The aim of the programme is to provide assurance for bothcommissioners and providers that the HRGs used as the basis for charginghave been correctly calculated. At The Royal Bournemouth andChristchurch Hospitals NHS Foundation Trust the error rate measured usingHealthcare Resource Groups (HRGs) has improved since the previousaudit.5 This year the HRG error rate at the Trust is 10 per cent. This is asignificant improvement compared to last year when the HRG error rate was24 per cent. The Trust is performing close to the national average (9.1 percent) when compared to the overall performance of trusts in 2009/10. TheTrust’s HRG error rate has varied over the four year period of theprogramme. However, further improvements in the accuracy of clinicalcoding could be made.6 Overall the Trust is improving the quality of the source document forcoding which in this Trust is a formal electronic discharge summary with thebenefit of in-house computer systems to back this up. The electronicdischarge summary is fairly comprehensive. However, this could beimproved by clinical staff providing more specific information as it stillaccounted for 4.3 per cent of primary diagnosis and 6.5 per cent ofsecondary diagnosis errors.Audit Commission Payment by results data assurance framework 2
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THE ROYAL BOURNEMOUTH AND CHRISTCHU
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50/11 DECISION3% by the 4 th quarte
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52/11 INFORMATIONClinical advice -
Page 9 and 10: THE ROYAL BOURNEMOUTH AND CHRISTCHU
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Analysis of errors - Chapter JC - S
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Appendix 6 - HRG area EB01Z - Nonin
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Analysis of errors - HRG EB01Z:All
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Appendix 7 - Ungrouped original Car
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KEYDESCRIPTIONcoding. This is where
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