Hospital ‘coding’ report may answer vital questions (From The Bolton News)

Hospital ‘coding’ report may answer vital questions

7:49am Wednesday 6th March 2013 in Local

A REPORT investigating “significant discrepancies” in data at the Royal Bolton Hospital is to be published today.

The report, completed by health information experts Dr Foster on a sample of 200 cases, will tell health bosses whether staff at the Bolton NHS Foundation Trust have been “coding” patients’ illnesses and causes of death incorrectly.

But Bolton’s Clinical Commissioning Group (CCG) has said some questions will remain unanswered by the report and a second investigation may be needed to discover the impact of the “coding” on death rates at the Trust.

If the report reveals there were no coding inaccuracies then a second investigation may also be needed to discover why there were such high numbers of septicaemia cases.

The report was commissioned by the CCG after figures showed there had been 800 cases of septicaemia, a severe infection that enters the blood stream, between March, 2011, and Apri,l 2012.

A similar-sized Trust would expect around 200 cases.

Dr Jackie Bene, the Bolton Trust’s acting chief executive and the medical director since 2008, has “stepped aside” while the investigation takes place.

The CCG is expecting the report to reveal whether the coding was compliant with national standards and expect it to give details about how any inaccuracies could affect the Trust’s finances.

If the Trust has been incorrectly coding cases of other illnesses and causes of death as septicaemia they may have received too much money in payments.

Septicaemia receives higher payments than other conditions, such as urinary tract infections. A spokesperson for the CCG said: “This report will give us more information about the veracity of the coding, whether the coding complied with national standards, an indicative financial impact, and help to identify our next steps.”

The report will not, however, reveal how many of the cases of sepsis — an illness in which the body has a severe response to bacteria or other germs — reviewed by Dr Foster were deaths or who the patients were.

The CCG will also still not know the potential impact it could have on death rates.

Septicaemia is coded, or tagged, in a different way to other illnesses and infections and is excluded from Dr Foster’s Hospital Standardised Mortality Rates (HSMR) formula, which works out mortality rates at hospital trusts across the country.

This means deaths caused by septicaemia do not affect mortality figures. If cases at the Trust have been incorrectly coded as septicaemia, Bolton’s mortality figures could increase.