THE final report into how sepsis was “coded” at the Royal Bolton Hospital has cleared the trust of any wrongdoing.

It also revealed clinicians in Bolton were doing an “exceptional” job identifying cases of sepsis and the report has exonerated medical director Dr Jackie Bene, who “stepped aside” when the original Dr Foster review into coding at the trust began in February, from any blame.

Health chiefs are now calling for a national review into the way sepsis is coded at foundation trusts across the country.

The report did find Bolton’s coding system did not meet health information expert Dr Foster’s criteria — but crucially found no issues with patient care.

In fact, it revealed Bolton was way ahead of other foundation trusts in the way it identifies and treats cases of sepsis early, which ultimately saves lives.

The report has raised questions about the way sepsis, which loosely means an infection, is understood by clinicians, coders and analysts across the country.

Dr Jackie Bene said: “I am of course very pleased that the review panel was assured that my colleagues and I only ever had the bet interests of patients and that there was no question of wrongdoing whatsoever.

“People can be assured that we will continue to put the care of patients above all else.”

Trust bosses, along with chiefs from Bolton Clinical Commissioning Group have now called for a “nationally agreed definition” of the term sepsis.

They have approached Dr Bruce Keogh, medical director for NHS England, about the national coding issues raised by the review team, which include differences in the interpretation between the diagnosis and coding.

The independent investigation, led by Kathy Doran, an experienced chief executive from Cheshire, Wirral and Warrington PCT cluster, and Dr Peter Williams, medical director at Royal Liverpool and Broadgreen University Hospitals Trust, with the help of Ron Daniels, chief executive of the Sepsis Trust UK, was launched in March after the Dr Foster review found coding did not meet national standards and had been retrospectively changed.

The alarm was initially raised by Dr Foster after finding that there were 800 cases of septicaemia at the hospital between March, 2010 and April, 2011, when a similar-sized trust would be expected to have had 200.

There were concerns the data had been manipulated to change mortality figures, to gain bigger payments from commissioners, or that poor patient care could have led to the increased number of cases of septicaemia.

But the review has shown that whilst coding at the Trust does not meet the standard Dr Foster criteria, patient care at the Trust is excellent.

In a joint statement, the CCG and the Trust said they would work together to improve coding.

Dr Wirin Bhatiani, chair of Bolton CCG and David Wakefield, interim chairman of the trust, expressed their confidence in Dr Bene.

Dr Bhatiani added: “While the coding issues that have been highlighted have no direct impact on quality of care, robust coding data is important to us. The CCG will work with the trust to further improve patient care, and also data quality for Bolton people.”

Mr Wakefield added: “The outcome of the review highlights the success of Dr Bene and her team. The approach to the early identification and treatment of possible sepsis has improved patient outcomes, and saved lives over a sustained period and patients in Bolton can be confident in the quality of care they receive in our trust.”