The job of clinical coding should be given a higher priority within NHS trusts in order to make payment by results work, according to the Audit Commission.

The job of clinical coding should be given a higher priority within NHS trusts in order to make payment by results work, according to the Audit Commission.

Announcing that the commission had been tasked with policing the way trusts code their activity, head of health Andy McKeon told HSJ that the quality of clinical coding was 'variable'.

He said that NHS trusts had to invest in the quality and quantity of their clinical coders to get the best results.

'The job of clinical coding is clearly going to become much more important,' he said. 'When money hinges on something it becomes much more important.'

Mr McKeon said primary care trusts should draw up contracts with acute trusts which included penalties for inaccurate coding.

And he admitted that results from the commission's clinical coding pilots across South Yorkshire and Avon, Gloucestershire and Wiltshire strategic health authorities showed that trusts were 'actively working to optimise their coding to maximise income, but within existing coding rules'.

The Department of Health has asked the Audit Commission to conduct external audits of those trusts which are under performing in the way they collect and collate data under payment by results.

Primary care trusts will have to pay the commission to be audited on their clinical coding. The amount has not yet been decided.

Results from the commission's clinical coding pilot also show a 'high level' of coding error. Across 12 acute trusts, coding inaccuracies averaged 11.9 per cent and ranged from 3.5-28 per cent.

Mr McKeon said that weaknesses in coding and accuracy were 'undermining confidence in payment by results'.

He said that the commission would be conducting a 'comprehensive national data analysis' which would allow trusts to benchmark themselves. They will also do spot checks on trusts that have a significant number of coding errors.