Every 13 minutes: Roy Lilley considers the state of clinical coding in the NHS

Roy Lilley at the CHKS Data Quality and Clinical Coding Conference 2015

This year’s CHKS Data Quality and Clinical Coding Conference was well attended with over 130 delegates from across the UK. Our aim was to discuss and share knowledge on improving data quality and promoting quality, value and transparency in healthcare.

Delegates had the opportunity to hear from national organisations, clinicians and sector leads on the importance of clinical coding to future developments. They were able to share experiences and best practice. You can find slide presentations from the day here.

Roy Lilley was one of our keynote speakers. He spoke forcefully and passionately about the importance of clinical coders. Coders he said, should realise how important they are to the future of the NHS. To run the NHS effectively and efficiently boards need to be able to answer five simple questions: why do people get sick? How do we fix them? Does it work? What did it cost and would we want to do it that way again? None of these questions could be answered if clinical coding departments didn’t exist.

However, he said that coders are not taken seriously enough, often finding themselves in unsuitable temporary accommodation, or tucked away in some dark corner of a hospital site. This needs to change. If he was still running a hospital trust he would have coders on his board of directors – a measure of just how important he feels the profession is to the NHS.

He argued that in the NHS we have the best data set in the world. We’ve been collecting data since 1946, but the problem is that we just don’t make enough use of it. This is something we see for ourselves and our experience tells us that without accurate data, the NHS will not function effectively. Trusts should invest in their coding departments.

We also understand the importance of promoting greater interaction between clinical coders and clinicians. If you want good quality data you have to make sure clinical coders spend time interacting with their clinical colleagues.

But Roy asked whether the current approach to clinical coding is sustainable. He worked out that coders have just 13 minutes to code each case, and if the case notes are poor, the information isn’t there or the junior doctor’s hand-writing is indecipherable, that becomes a very tall order. He said that he was surprised that the error rates identified through CHKS’ audit programmes are so low given all the challenges coders faced. And he said we needed to think about how we could do things differently, using technology to help, to reduce the burden on an already over-stretched profession.

You can watch a video for the highlights from Roy’s speech below.