Tom Dewar's Comments
Comment on: An introduction to clinical coding
"millions of pounds worth of savings" - Anon 4:09 Paid in fools gold maybe. Coding accuracy is an important thing, but to assume all errors are one way, that correcting them always increases income, is naive in the extreme. The Audit Commission, from there annual audits of clinical coding, find that there is no evidence for gaming - meaning the errors they find are as likely to be in the trust's favour as not. By all means put in place sensible processes to improve coding quality - regular audits, coder-consultant dialog, improve medical record keeping, automated sense-checking rules, regular feedback of coded activity info to consultants etc. - just don't go banking on a big income boost as a result.* (*Of course you could cherry pick and only look for and fix errors in your favour, but you'll end up at pointless and expensive loggerheads with commissioners in due course. I'd suggest efforts are better directed into finding ways to save money for the health economy rather than just moving money from one organisation to another within it.)
Comment on: Improving the diagnosis and referral process
Sounds like good stuff. Probably too late, but you had the perfect oppoturnity to test the effectiveness by randomised-control-trial (RCT). Take a randomly chosen subset of your 35 practices (not just the keen ones) as your test group, another random set as your control, implement the new system with the test group and compare outcomes (referral rates etc.)
Comment on: Chief executives not confident on out-of-hours safety
Read the main report itself (which the HSJ have kindly included a link to). Ignore the truely awful use of pie charts. The included comments from CEs are much more interesting than any of the scores-out-of-ten which the HSJ has chosen to report here.
Comment on: Chief executives not confident on out-of-hours safety
Read the main report itself (which the HSJ have kindly included a link to). Ignore the truely awful use of pie charts. The included comments from CEs are much more interesting than any of the scores-out-of-ten which the HSJ has chosen to report here.
Comment on: NHS managers enjoy largest jump in basic pay
Pretty disappointed to see the HSJ cherry picking this statistic and turning it into a misleading headline. I'm afraid these statistics don't mean an awful lot. For example this could be explained by fewer senior managers being at the top of their AfC band. And the distribution of pay for senior managers is skewed: the mean (average) is artificially inflated by the relatively small number on high VSM salaries. A relatively small increase in these high salaries would inflate the apparant growth by this measure. It would have been much more interesting if the Information Centre had given a breakdown by AfC grade + pay point. Finally, the pedant in me thinks it should have been made clear in the article that these figures cover "Hospital and Community Health Service" staff only (i.e. they exclude SHAs, PCTs etc.)
Comment on: Financial squeeze on NHS providers to continue in 2013-14
Anon 2:16 - More care? So your CCG is happy for you to do 1.3%+ more, on top of underlying growth in demand?
Comment on: Financial squeeze on NHS providers to continue in 2013-14
So, 2.3% more in the NHS kitty, but we've to spend 1.3% LESS on patient care. I'm I the only person who feels these numbers are the wrong way around?
Comment on: Bring in hospital 'superheads' to tackle poor performance, says Hunt
Three questions spring to mind. 1. This pre-supposes the main problem is poor leadership. Are we sure that's really the main problem? 2. Have we a sound evidential basis yet that the "superhead" approach in education effects enduring benefits? 3. Where are the super-CEOs (if that's what we'd call them) going to come from?
Comment on: A&E waiting times rising - survey
I'm confused. If 95%+ of patients attending A&E are seen within 4hrs (we are all still meeting that target aren't we?), how come 25% report it taking more than 4hrs?
Comment on: Is bigger better for the NHS?
Nice analysis guys. Always refreshing to see someone look at the numbers rather than just adding to the rhetoric. Nate Silver would be proud.
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