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PbR Data Assurance Framework

PbR Data Assurance Framework. What is it?What did we find out?What should you do?What's coming next?. The assurance framework. A rolling programme of external audits covering inpatients and outpatientsProviding assurance of the accuracy (or not) of coding and therefore payments made to providers

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PbR Data Assurance Framework

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    1. PbR Data Assurance Framework Key Messages

    2. PbR Data Assurance Framework What is it? What did we find out? What should you do? What�s coming next?

    3. The assurance framework A rolling programme of external audits covering inpatients and outpatients Providing assurance of the accuracy (or not) of coding and therefore payments made to providers Driving improvements in data quality and clinical coding arrangements National analysis to identify significant trends and share good practice Development of online benchmarking function to support PCTs & trusts

    5. PbR assurance 2008/09 Continuation of clinical coding audit programme at all acute trusts (follow up on recommendations) Reviews of outpatient data quality at approximately a third of trusts Piloting of reviews covering the independent sector Further development and refinement of the national benchmarker Research into key areas from 2007/08

    6. Lessons learnt

    7. Findings and recommendations

    8. HRG errors (2007/08)

    9. HRG errors (Qs 1-3 2008/09)

    10. Individual trust change

    11. Individual trust comparison

    12. Gross financial error (2007/08)

    13. Net financial error (2007/08)

    14. Net financial error (Qs 1-3 2008/09)

    15. Coding errors (Qs 1-3 2008/09)

    16. Key themes & local action

    17. Key themes & national action

    18. Key themes & Commission action

    19. PbR assurance � the road ahead

    20. PbR assurance next year (2009/10) 2009/10 (yr3) continuation of programme Allows broader understanding of data quality and each trust Key changes in PbR HRG4 -- new tariff -- OPCS 4.5 -- MFF -- SUS Piloting A&E audits Reference costs

    21. Impact on HRG4 Sense check analysis Compared impact under HRGv3.5 & HRG4 Error rate slightly higher under HRG4 Overall financial impact still relatively neutral Volatility for individual trusts and specialities Local action required to understand impact

    22. Risk based approach 2010/11 (yr4) move to risk based approach Consulting with NHS in the summer Proportionate approach Do more at less trusts Integrate all audits More data items Wider scope

    23. PbR National Benchmarker

    24. PbR National Benchmarker tool Powerful online tool freely available to the NHS Developed as part of the assurance framework Robust and sophisticated benchmarking methodology 42 separate indicators covering both inpatient and outpatient data Focus on data quality but relevance beyond PbR

    25. Data explorer

    26. Scorecard viewer

    27. HRG4 benchmarking PbR National Benchmarker updated with HRG4 benchmarking May 2008 Developed in conjunction with NHS Information Centre New HRG4-specific indicators, including: Unbundling Planned same day Short stay elective Improved functionality

    28. So what should you do? Identify areas for improvement Review findings from audits Implement action plans Understand your data Ratify data with SUS PbR National Benchmarker Understand impact of HRG4 and new tariff

    29. For more information� www.audit-commission.gov.uk/pbr

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