Comment / Start with the data

Good-quality data is fundamental to providing the right care to the right patient in the right place. That applies to activity data in its own right, but also to costing data, which is so dependent on the accuracy of activity data.

As we move to greater system working, patient-level costing information will be particularly important to the decisions that need to be made across multiple services, pathways and organisations both to manage current services and determine the future models of care. It will also be integral to understanding the underlying financial positions of systems and supporting the NHS when financial baselines are reset following the pandemic.

The joint HFMA Healthcare Costing for Value Institue and Grant Thornton briefing Costing and data quality, published this week, identifies that the quality of the activity data needed for costing is poor in key areas. This has a fundamental impact on the ability of NHS organisations and systems to make good decisions.

A survey of 55 NHS trusts revealed that while inpatient activity was generally reliable, the same was not true for services outside hospital. Data quality for mental health and community physical health services was exceptionally poor. Until data quality is improved in these areas, healthcare systems will struggle to understand the use of resources across patient pathways.

Data for other key activities such as theatres and pathology was also reported to be of a poor quality, making it hard for the NHS to plan future models of care.  And the lack of information about medical staff activity makes it difficult to explore new ways of working.

The data we are talking about here is not only used for costing.  It is the same data that is used in Getting It Right First Time and the Model Hospital, as well as in individual organisation performance metrics. How can boards and system leaders effectively manage services with poor-quality data?

Board members, system leaders and clinical staff all have a role to play in improving the quality of data. Are they confident that the quality of their data is good enough to support value-based decisions?  Does their organisation have robust data governance structures in place?

Payment by results led to improvements in data recording, with accurate coding, counting and costing having a direct impact on the amounts organisations paid or received for the care that was delivered. But with the move away from national tariffs, there will need to be broader recognition of the value of high-quality data.

There are things that organisations can and should be doing. Boards should ensure that the information given to them to inform decisions is subject to assurance and scrutiny. Clinicians need to own the data they produce and make sure they are part of validation exercises. And system leaders should make certain that the data from across different organisations is reported in a consistent and accurate way.

The briefing provides further pointers on what needs to happen to improve management information.

However, while digital solutions offer opportunities for better data capture, there are no quick fixes. The starting point has to be a recognition of the importance of data quality and a concerted effort to deliver improvements.

Click here to find out more about the Healthcare Costing for Value Institute’s programme.