PCTs lose money through incorrect clinical coding

Hospitals are overcharging PCTs by up to 14 per cent because of incorrect clinical coding, an Audit Commission report has revealed.

In some trusts, more than a quar-ter of clinical coding was wrong, the report found.

Some of the errors could be evidence of fraud, the report sug-gests. It highlights ‘concerning practice’ in some areas in which clinical coding teams report to fi-nance directors to ‘discuss the fi-nancial impact of coding changes on a regular basis’.

This practice ‘increases the like-lihood of manipulation’, the report says.

The scale of erroneous reporting is undermining the Payment by Results tariff system for paying hospitals, ‘raising concerns about the accuracy and fairness of fund-ing flows’.

The report calls for the DoH to introduce set financial penalties that would cut pay for the worst offenders by the end of 2006/7.

It also calls for a large-scale audit system to detect errors or fraud by trusts, which would cost up to £30,000 per PCT to implement.

The findings could have negative implications for GPs’ ability to control spending and generate savings under practice-based commissioning.


Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Just published

BMA Scotland GP committee chair Dr Andrew Buist

'Disappointing' uplift falls short of 6% pay rise promised to GPs in Scotland

A 'disappointing' uplift to contract funding worth £60.4m in 2023/24 will not deliver...

Person selecting medicine in a dispensary

Dispensing GPs demand funding overhaul to ensure services remain viable

Dispensing doctors have demanded improved representation in GP contract negotiations,...

GP consultation room

GPs seeing cases of malnutrition and rickets as cost-of-living crisis hits patient health

Three quarters of GPs are seeing a rise in patients with problems linked to the cost-of-living...

Female GP listening to a patient

What GPs need to know about changes to Good Medical Practice

Dr Udvitha Nandasoma, the MDU’s head of advisory services, explains what GPs need...

Dr Caroline Fryar

Viewpoint: Doctors should be given protected time to digest Good Medical Practice

There's a lot for doctors to digest in the GMC's Good Medical Practice update before...

MIMS Learning Clinical Update podcast

MIMS Learning Clinical Update podcast explores the ‘defining issue of our age’

The latest episode of the MIMS Learning Clinical Update podcast features an interview...