The current system of payment by results is 'fundamentally flawed and unacceptable' the head of the Professional Association of Clinical Coders warned last week.
Managing director Sue Eve-Jones told an HSJ conference last week that the quality of data in the NHS could compromise any chances of ensuring fairness under PbR.
Her presentation was subtitled 'doing the best we can with a fundamentally flawed and unacceptable system'.
Ms Eve-Jones said that healthcare resource groups, the standard treatment groupings used as units of currency within the health service, 'are not designed to support payment systems and we are using them to support PbR'.
She painted a bleak picture of NHS data accuracy, blaming poor training and support for coders, Department of Health tariffs that have 'no bearing on the real service', and pressure to 'upcode' to generate more cash.
'Some coders are asked by clinicians &Quot;which code will give me a better HRG?&Quot;, or you see directors of finance wandering around saying &Quot;we need more codes&Quot;. I am pleased to say that most coders are immune to this.'
And Ms Eve-Jones concluded that the NHS payments system 'scares me witless'. 'It's like going into Tesco, filling up your basket, and getting charged different prices depending on which checkout you go to.'