Welsh health boards have been making slow progress in clinical coding, restricting the ability to use hospital data for statistical and management purposes, according to the country’s central auditor.
Audit Wales has published a report on the issue that calls for more investment in the process to support the use of digital systems.
“The significant step-change in the use of digital platforms during the pandemic has created an opportunity for NHS bodies to increase the extent to which digital records are utilised, increasing with it the scope to reduce the time it takes to code activity, and support smarter and flexible working by clinical coding staff,” Audit Wales said in an accompanying statement.
It added: “Clinical coding continues to have a low profile at board level, and arrangements could be enhanced by critically examining the level of investment in resources, good quality source information and engagement medical staff in the coding process.”
The report is based on the organisation’s local audit work – it examined arrangements at seven health boards in 2018-19 – and points to the potential to use changes made during the Covid-19 pandemic in finding new ways to deliver coding work.
Its key facts include that, at end of April this year, 83% of consultant episodes of care had been coded within one month, well below the 95% target set by the Welsh Government. This is against the background of about 1.1 million episodes of care to be coded each year.
Meanwhile, around £5.9 million per year is spent on clinical coding in the NHS across Wales.
“Over the last six years, there have been improvements in the timeliness and accuracy of clinical coding data,” the report says. “However, there are backlogs of uncoded activity in some parts of Wales which can date back several years.
“The current target of a one-month turnaround time does not support the availability of clinical coded data on a close to real-time basis, something which has been shown to bring significant benefits in helping to understand patterns of demand on hospital services during the current pandemic.”
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