The UK Audit Commission released a report today that flagged concerns over data quality for the Payment by Results (PbR) data assurance programme.
'Improving coding, costing and commissioning: Annual report on the Payment by Results data assurance programme 2010/11' cites a range of data quality issues including:
- 1 in 8 trusts’ reference cost submissions were inaccurate
- 1 in 4 individual unit costs were materially inaccurate
- Accurate coding of patients who have several health problems remains a concern
- Source documentation again highlighted as an issue
- Poor data quality found to be higher in independent hospitals supplying services to NHS, coding diagnoses a key cause however the reported remarked that source documentation was good quality when compared with NHS
- Independent sector (IS) hospitals were found to have an average error rate of diagnosis coding more than twice that of their NHS counterparts
- Of the trusts that were aware of their poor data quality issues, about a third of them were still content to submit inaccurate data
According to the report this level of poor quality data has national implications as this information is used to create accurate contracts of payment with the trusts.
The Audit Commission cited the need for "Greater use of simple, basic checks” and other improvements such as:
- Checking submissions against other data sources
- Benchmarking unit costs against other providers
- Better senior leadership within organisations
- Greater clinical involvement
In particular, the report cited the importance of increased board engagement on data quality and a more consistent framework to "define, assure and support improving data quality in the NHS”.
To help address the issues found, the report provides a 10 point checklist that senior hospital managers can use to improve the quality of reference cost submissions. The Audit Commission are also sharing the tools they used to perform their assessment via an online mechanism so that trusts can benefit from adopting the same checks as the Audit Commission.
One important observation in the report was that over a third of trusts knew they had instances of poor quality data but simply refused to make any efforts to resolve the defects. This points to a clear lack of data governance at management level given the importance of the underlying data.
There are promising signs that the NHS is making progress in an effort to improve poor data quality but it’s clear there are considerable hurdles ahead.
The report can be downloaded at the Audit Commission website: http://www.audit-commission.gov.uk/nationalstudies/health/pbr/pbr2011/Pages/pbr2011.aspx