News
Present on Admission Flag
Posted Jan 2012
The Daily Telegraph (Friday 27th January 2012) has reported on its front page that a group of experts led by the Care Quality Commission has written to the government asking it to ensure that hospitals always note the presence of bedsores, falls and infections when patients are admitted. Members can read a copy of the front page article by clicking here.
The letter argues that a POA (present on admission) flag should be implemented and makes the point that a POA system would provide "a clearer picture of both the quality of social and hospital care".
The letters signaturies include Cynthia Bower, the chief executive of the Care Quality Commission, Peter Carter, chief executive of the Royal College of Nursing, Margaret Hodge, chairman of the Commons public accounts committee and is backed by the PACC-UK and 16 hospital trusts. The POA campaign was launched by Dr Foster Intelligence last year and the PACC-UK, which has been an advocate of such an indicator for some time, became involved shortly after. Members can view the contents of the letter by clicking here. (Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
Coding Clinic
Posted Jan 2012
The Jan 2012 v1.1 NHS CFH Coding Clinic has just been published. It is available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
ICD-10 Edition 4 Books Available
Posted November 2011
The New Edition of the WHO ICD-10 incorporating WHO updates up till 2010 is now available. There are significant changes to the scheme. The publication is available through the TSO (The Stationary Office). For more information you should visit the NHS CFH Classifications website.(Members can download more information by clicking here.. Contact webmaster@paccuk.org if you are a member and are having difficulty.)
The cost of the publication is £365.00 plus postage. The NHS is entitled to a discount until the 9th December. Information about how to order is available either from the NHS CfH website or from the download above.
Hospitals Respond to SHMI Publication
Posted November 2011
The HSJ (Health Service Journal) has reported that 9 of the Trusts recently named as having a greater than expected death rate in the recently published Summary Hospital Level Mortality Indicators (SHMI), have blamed their high figure on clinical coding rather than their quality of care. The HSJ has further reported that four of these Trusts said they were rated high because the indicator did not take into account whether patients were admitted to receive palliative care. Veena Raleigh, Senior Fellow at the King's Fund, a member of the technical group that developed the SHMI, said that the impact of palliative clinical coding was a "valid issue":.
Alastair Turnbull, Medical Director at York Teaching Hospital Foundation Trust blamed his organisations's rating on the inclusion of data from a hospice on the York Teaching Hospital site which is not run by the Trust. The Blackpool Teaching Hospitals Foundation Trust said that the new indicator does not take into account levels of deprivation which has put it at a disadvantage. However the George Eliot Hospital Trust in Warwickshire, which had the largest gap between expected and observed deaths under the SHMI, said it was taking the rating "extremely seriously" and has commissioned an external review.
The British Medical Association consultants committee chair, Dr Mark Porter said the measures should not be used in isolation. He went on to echo the view of the Department of Health and the NHS Information Centre which recommends that the SHMI should be used as a 'smoke alarm' giving warning of a potential problem which should be investigated.
First SHMI Mortality Indicator Results Published
Posted October 2011
Fourteen hospital trusts have been identified as the poorest performers in the first publication of the new official hospital-wide mortality ratings.
The NHS Information Centre (NHSIC) has published the first Summary Hospital-level Mortality Indicator (SHMI) results for all non-specialist acute trusts and 14 NHS Trusts have been given thelowest banding. The 14 trusts are:
- George Eliot Hospital NHS Trust
- Isle of Wight NHS Primary Care Trust
- East and North Hertfordshire NHS Trust
- Blackpool Teaching Hospitals NHS Foundation Trust
- Tameside Hospital NHS Foundation Trust
- Medway NHS Foundation Trust
- York Teaching Hospital NHS Foundation Trust
- Northern Lincolnshire and Goole Hospitals NHS Foundation Trust
- Basildon and Thurrock University Hospitals NHS Foundation Trust
- Hull and East Yorkshire Hospitals NHS Trust
- Northampton General Hospital NHS Trust
- East Lancashire Hospitals NHS Trust
- University Hospitals or Morecombe Bay NHS Foundation Trust
- Western Sussex Hospitals NHS Trust
Fourteen trusts recieved the highest banding. They are:
- The Whittington Hospital NHS Trust
- Barts and the London NHS Trust
- University College London Hospitals NHS Foundation Trust
- Imperial College Healthcare NHS Trust
- Royal Free Hampstead NHS Trust
- St George's Healthcare NHS Trust
- Chelsea and Westminster Hospital NHS Foundation Trust
- Cambridge University Hospitals NHS Foundation Trust
- Newham University Hospital NHS Trust
- North West London Hospitals NHS Trust
- Sheffield Teaching Hospitals NHS Foundation Trust
- Kingston Hospital NHS Trust
- James Paget University Hospitals NHS Foundation Trust
- Ealing Hospital NHS Trust
The SHMI is intended to provide an indicator to enable Trusts to probe potential problems with their quality of care. The NHSIC Chief Executive, Tim Straughan, stressed it was only one indicator and could not reveal all the problems in the NHS. In a statement he said "The SHMI is best treated as a 'smoke alarm' that should be used locally by individual hospital trusts to assess and investigate their mortality-related outcomes". He went on to say, "Though a powerful measure, it should not be taken in isolation as a headline figure of trust performance. It requires careful interpretation and for that reason it is not specifically tailored for use by patients or the public, though we understand there will be clear interest in it".
The new measure monitors deaths in hospital as well as those within 30 days of discharge. It was developed after the scandal exposed at the Mid Staffordshire NHS Trust in 2009,where between 400 and 1,200 excess deaths were not identified. It is intended that the SHMI will be published quarterly.
The ISB Approves SNOMED-CT
Posted August 2011
The ISB (Information Standards Board for Health and Social Care)) has officially approved SNOMED-CT as a 'fundamental standard'. SNOMED CT is an internationally recognised set of numerical, machine readable codes and human readable descriptions, which can be used to uniquely identify clinical concepts. Simon Burns MP said that adopting it should mean "much clearer and more consistent communication between hospitals and GPs" and "help patients better understand their care records." The ISB said that the standard defines the rules for administering SNOMED CT in England, however the ISB has not yet mandated its use for healthcare providers, "Further standards will be submitted to ISB to show that SNOMED CT can be used to support key functions within the NHS, such as the clinical management of the patient within general practice and secondary care,".
The SNOMED CT is owned and managed by the International Health Terminology Standards Development Organisation (IHTSDO) based in Denmark.
Dr James Read dies
Posted July 2011
The original author of the Read Codes, Dr James Read, has died. The Read Codes which subsequently became the Clinical Terms V3, were merged with the American SNOMED-RT to form what we now know as SNOMED-CT. The Read codes began life in the 1980s in Loughborough where Dr Read was a GP. The original version was a four character code structure and was often known as Read V1 or 4-Byte Read. An NHS operational need to map the Read Codes to the then ICD-9, resulted in the creation of Read version 2 or 5-Byte Read (subsequently known as Clinical Terms V2 or CTV2). The intellectual copyright of the Read Codes was purchased by the UK Government and remain Crown Copyright. A more radical version of the Read codes was devised in the 1990s and these became known as the Clinical Terms V3 or CTV3.
DH Chief Information Officer Resigns
are stillPosted June 2011
Christine Connelly, the Department of Health Chief Information Officer has resigned. She is to be temporarily replaced by Katie Davis who is currently Exectutive Director of Operational Excellence in the Efficiency and Reform Group at the Cabinet Office. Her resignation follows the announcement of further delays to the publication of the DH's Information Strategy which will not now be released until the Autumn. The Information Strategy is needed to provide direction for the pulling together of patient records and provide more information for patient and commissioner choices of NHS services. The NPfIT programme has recently come under fire from MPs for not delivering on its objectives and for wasting billions of pounds.
High Cost Drugs and Chemotherapy lists
Posted April 2011
The 2011 High Cost Drugs list and Chemotherapy Regimens List have been re-issued. A number of mistakes have been corrected. They are available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
Coding Clinic
Posted March 2011
The Volume 7 Issues 9 March 2011 NHS CFH Coding Clinic has just been published. It is available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
High Cost Drugs and Chemotherapy lists
Posted March 2011
The 2011 High Cost Drugs list and Chemotherapy Regimens List have now been published. They are available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
Liberating the NHS - ICD-10 Update
Posted March 2011
As previously reported on this website, the Government has published its White Paper – Equity and excellence: Liberating the NHS. As part of the changes being passed into law, the white paper indicated the new Governments intention to implement the latest edition (edition 4) of ICD-10. The NHS Classifications Service have now announced that they are beginning the necessary development work to support the implementation of the ICD-10 4th Edition. A summary of changes has been published. (Members can access a direct link from the Inform page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.) They have also announced that several ICD-10 updates focus groups will be held early in the new financial year (2011-12) primarily for the coding community to review the updates and identify training needs.
Coding Clinic
Posted March 2011
The Volume 7 Issues 7 and 8 March 2011 NHS CFH Coding Clinics have just been published. They are available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
NHS Outcomes Framework
Posted December 2010
The Department of Health (DH) has published the first NHS outcomes framework. The government intends to concentrate onoutcomes rather than on performance management. There are 10 over-arching indicators which cover the broad aims of each area, 31 improvement area indicators which look in more detail at key areas within each domain; which are divided between 5 healthcare domains which articulate the responsibilities of the NHS (in total there are 51 indicators). For the period 2011-12 there are no targets primarily as there is insufficient reliable information as yet. Thereafter the Health Secretary and the NHS Commissioning Board will identify areas "of ambition" for improvment.
- Domain 1 - Prventing people from dying prematurely
- Domain 2 - Enhancing quality of life for people with with long-term conditions
- Domain 3 - Helping people to recover from episodes of ill health or injury
- Domain 4 - Ensuring that people have a positive experience of healthcare
- Domain 5 - Treating and caring for peopl in a safe environmnet and protecting them form avoidable harm
Members can access a copy of the NHS Outcomes framework here.
Coding Clinic
Posted December 2010
The Volume 7 Issue 6 December 2010 NHS CFH Coding Clinic has just been published. It is available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
NHS Outcomes Framework
Posted December 2010
The Department of Health (DH) has published the first NHS outcomes framework. The government intends to concentrate onoutcomes rather than on performance management. There are 10 over-arching indicators which cover the broad aims of each area, 31 improvement area indicators which look in more detail at key areas within each domain; which are divided between 5 healthcare domains which articulate the responsibilities of the NHS (in total there are 51 indicators). For the period 2011-12 there are no targets primarily as there is insufficient reliable information as yet. Thereafter the Health Secretary and the NHS Commissioning Board will identify areas "of ambition" for improvment.
- Domain 1 - Prventing people from dying prematurely
- Domain 2 - Enhancing quality of life for people with with long-term conditions
- Domain 3 - Helping people to recover from episodes of ill health or injury
- Domain 4 - Ensuring that people have a positive experience of healthcare
- Domain 5 - Treating and caring for peopl in a safe environmnet and protecting them form avoidable harm
Members can access a copy of the NHS Outcomes framework here.
Revised Operating Framework Published for 2010/11
Posted December 2010
The revised operating framwork for the NHS in England has been published. THe oeprating framework sets out the priorities for the NHS in England for the forthcoming year. There are significant changes in the indicated as the NHS will have to deliver better value for money and support the creation of a healthier nation. The framework focuses on 5 key areas:
- revisions to Vital Signs and Existing Commitments
- new rules on configuration
- future direction and next steps on transforming community services
- finance and efficiencies
- accelerating development of the payment system
Members can access a copy of the revised operating framework here.
OPCS 4.6 DRAFT Summary of changes document
Posted November 2010
The NHS Classification Service has published a DRAFT list of the changes to codes and descriptions to the OPCS 4.5 Tabular list for OPCS 4.6. The final document is expected in January 2011. The document is draft and clinical coders should not annotate their OPCS 4.5 Tabulars with this information. The document has been published by the classifications service to give indications of the proposed changes to system suppliers.
Members can access the OPCS 4.6 Draft Summary of Changes here.
New Hospital Indicator to be Published
Posted November 2010
Following a national review, the Department of Health (DH) has announced that the way hospital mortality ratios will be calculated will change. The Summary Hospital Level Mortality Indicator (SHMI) should be used by hospitals to better understand the trends associated with patient death. The review followed as a result of the Francis inquiry into the Mid Staffordshire NHS Foundation Trust. The Mortality review was led by Ian Dalton, chief executive of NHS North East and included a wide range of organisations including the Academy of Royal Colleges, the Care Quality Commission, the NHS Confederation, Dr Foster Intelligence, the National Patient Safety Council, Sir Brian Jarman of Imperial College and the Professional Association of Clinical Coders - UK amongst others.
The new indicator (SHMI) is not designed to be used as a standalone indicator of quality to rank hospitals in league tables. It is instead designed to act as an indicator (smoke alarm) of a potential problem that requires investigation. Sir Ian Dalton said "A high SHMI on its own is not an indicator of poor standards of care but it is a trigger to take action. Hospital boards across the country have a responsibility to pursue questions the SHMI might raise and quick action will help to ensure safe care for patients at all times".
Members can access the DH press release and the Health Service Journal news piece here.
Coding Clinic
Posted October 2010
The Volume 7 Issue 5 October 2010 NHS CFH Coding Clinic has just been published. It is available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
Liberating the NHS - DH Consultation
Posted October 2010
The Department of Health is consulting on its White paper, Equity and Excellence.
This is part of the government's goal to give patients more information, control and greater choice about their care. The paper, The Information Revolution, is about transforming the way information is accessed, collected, analysed and used, putting people at the heart of health and adult social care services.
The DH is consulting on the proposals and the consultation will close on the 14th January 2011. A copy of the executive summary is available to members by clicking here.
The Future of NPfIT
Posted September 2010
A Review of the National Programme for IT undertaken by the Department of Health has concluded that a centralised, national approach to IT is no longer required. After 8 years, the government has officially called an end to the programme.
The new approach should allow NHS organisations to introduce smaller, more manageable change which is in line with their business requirements. The review reflects the governments commitment to ending top-down government and enabling localised decision making.
Christine Connelly, the Director General for Informatics, said "It is clear that the National Programme for IT has delivered important changes for the NHS including an infrastructure which the NHS today depends on for providing safe and responsive health care. Now the NHS is changing, we need to change the way IT supports these changes bringing the decision making closer to the front line and ensuring that change is manageable and holds less risk for NHS organisations."
Health minister Simon Burns said that moving IT systems closer to the front line would save £700m.
Audit Commission to close
Posted August 2010
The Government has announced the closure of the Audit Commission from 2012 saying that it has "more than fulfilled its goals". The move is set to save an estimated £50 million a year.
Eric Pickles, the Communities Secretary said, "Rather than being a watchdog that champions taxpayers' interests, it has become the creature of the Whitehall state." The Audit Commission said that the announcement had "come out of the blue".
The Audit Commission was set up by Michael Heseltine in 1983. The Commission has had a number of successes namely the rate capping scandals in Lambeth and Liverpool, the gerrymandering for votes scandal in Westminster and more recently the detection of over £200 million of fraud through the National Fraud Initiative.
Mr Pickles announced that whilst the Commissions research function would stop, there would be a "new audit framework" for local health services. He went on to say that "Audit should remain to ensure tax payers's money is properly spent, but this can be done in a competitive environment, drawing on professional audit expertise across the country".
Feedback on Classification Service Co-morbidity guidance
Posted August 2010
The CfH National Classification Service is seeking feedback on the co-morbidity guidance issued in the coding clinic in March 2010 (volume 6, Issue 6). The NCS is meeting again in September to progress with the next phase of the project. Feedback from the service is required by the 17th August. The Association has collated members views and the views of delegates to the INSIGHT 2010 event in London in May. Click here to view the Associations response to the NCS. Click here to view the grid with comments that was attached.
Review of Arms Length Bodies
Posted August 2010
The secretary of state for health, Andrew Lansley, has announced a cull of 'quangos' to save £180m in the health sector by 2014-15.
Subject to Parliamentary approval, organisations, which are not required, will be removed, with essential work moved to other bodies. The cull will claim high-profile organisations such as the Health Protection Agency, the National Patient Safety Agency, the Human Fertilisation and Embryology Authority, the Food Standards Authority, the Alcohol Education and Research Council and the Health Protection Agency.
The NHS Information Centre for Health and Social Care (NHS IC) will be retained and put on a firmer statutory footing. It will become a "national repository for data collection across healthcare, public health and adult social care" as outlined in the white paper. It will also have a "clearer focus on data collection" and a close working relationship with the new NHS Commissioning Board, which the white paper proposes to make responsible for information governance, data quality and systems interoperability.
NHS Connecting for Health was not included in the review.
WHO and IHTSDO Announcement
Posted July 2010
The WHO have made the following announcement (dated 22/07/2010). "WHO and the International Health Terminology Standards Developement Organisation (IHTSDO) have worked on a collaborative arrangement to link the WHO Family of Classifications and Systematised Nomenclature of Medicine - Clinical Terms (SNOMED-CT). This arrangement enables the linkage of terminologies and classifications. In the era of computerisation of health information and electronic health records, it represents a major achievement." The IHTSDO has also issued a press release which states "Copenhagen, Denmark, July 22,2010. - The International Health Terminology Standards Development Organisation (IHTSDO) announced today a collaborative arrangment with the World Health Organsiation (WHO) to harmonize WHO classifications and SNOMED-CT for the benefit of citizens around the world." Members can read the WHO announcement and the IHTSDO press release here. If you are a member and are having difficulty logging in to the Members area.)
Implementation of latest version of ICD-10
Posted July 2010
The coalition government has made clear its intentions to implement the latest version of ICD-10 Edition 2 in the NHS in 2012/13. It sets out its plans in the White Paper "Equity and Excellence: Liberating the NHS". For more information see the Association Newsletter, Inform July 2010. To view the White Paper itself click here. (Please contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
Coalition sets out its plans for the NHS
Posted July 2010
The coalition government has set out plans for the NHS in a white paper entitled "Equity and Excellence: Liberating the NHS". It describres a process for devolving power from government, making the NHS more accountable to patients and reducing bureaucracy. More information can be found in the Association Newsletter, Inform July 2010. (Please contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)To view the White Paper itself click here.
The Association Newsletter
Posted July 2010
The Association has launched an e-Newsletter for members. This is an intermittent publication and members can access it via the Inform page in the members section of this site.
Coding Clinic
Posted July 2010
The Volume 7 Issue 4 June 2010 NHS CFH Coding Clinic has just been published. It is available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
Coding Clinic
Posted July 2010
The Volume 7 Issue 3 June 2010 NHS CFH Coding Clinic has just been published. It is available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
Coding Clinic
Posted June 2010
The Volume 7 Issue 2 May 2010 NHS CFH Coding Clinic has just been published. It is available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
Clinical Coding Acadamies
Posted May 2010
As part of the on-going collaboration with clinical coders and those involved in their professional training. The NHS Classifications Service is developing Clinical Coding Academies as a way forward to enhance the future training needs of those working daily in the field. The first three Academies are with Calderdale and Huddersfied, London, and Cheshire and Merseyside; with a number of other training teams already keen to be part of the next phase. An oversight steering group, of which the PACC-UK is an active member, is helping to shape that development. In colloration with the NHS Information Centre, the plan is to look at the wider Education, Training and Development needs of the clinical coders and be able to respond to these through the Academy structure. For further details see www.connectingforhealth.nhs.uk/systemsandservices/data/clinicalcoding/trainingaccred.
Education, Training and Development
Posted May 2010
At the Associations INSIGHT 2010, as part of his presentation, Brian Derry, Executive Director at the NHS Information Centre for Health and Social Care (NHS IC) indicated that the NHS IC would be taking a more active role for clinical coding education, training and development from the NHS Connecting for Health.
NCCQ
Posted April 2010
The Association has recently learned that NHS Connecting for Health, Classifications Service have agreed with the IHRIM(UK) that those wishing to take the National Clinical Coding QUalification must first join IHRIM(UK). This is a change to previous practice where IHRIM(UK) offered a one year free membership to those undertaking the NCCQ as part of the cost of the NCCQ. This means that the cost of the NCCQ is now £350.00 (for NHS employees) or £450.00 (for non-NHS employees) plus an additional £90.48 for IHRIM(UK) annual student membership.
Coding Clinic
Posted March 2010
The Volume 6 Issue 7 March 2010 NHS CFH Coding Clinic has just been published. It is available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
Coding Clinic
Posted March 2010
The Volume 6 Issue 6 March 2010 NHS CFH Coding Clinic has just been published. It is available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.) This is an important coding clinic outlining the new national standards pertaining to the mandated recording of over 60 comorbidities if recorded in the record from the 1st April 2010.
High Cost Drugs list and Chemotherapy Regimen Lists 2010
Posted March 2010
The NHS CfH has issued the latest version of the high cost drugs list and chemotherapy regimens list for use in 2010.These are available via the TRUD service. (Members can access a direct link from the National Standards page in the Members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
Coding Clinic
Posted February 2010
The Volume 6 Issue 5 February 2010 NHS CFH Coding Clinic has just been published. It is available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)
INSIGHT 2010 - Orthopaedics
Posted February 2010
This years INSIGHT event will be on the subject of Orthopaedics. The event will take place at the Methodist International Centre in Euston Street, London on the 17th May 2010. Topics will include surgery of the spine, the shoulder and the foot.
Booking for members has opened and booking for non-members will open on the 31st March (although non-members may reserve a place). Places will be offered thereafteron a first-come first-served basis. For more information, to reserve a place or to download an application please visit the Events page of this site.
Coding Clinic
Posted January 2010
The Volume 6 Issue 4 January 2010 NHS CFH Coding Clinic has just been published. It is available for download from the NHS CFH Classifications website.(Members can access a direct link from the National Standards page in the members section . Contact webmaster@paccuk.org if you are a member and are having difficulty logging in to the Members area.)