Audit Commission publishes annual report on the Payment by Results data assurance programme


The Audit Commission’s Payments by Results (PbR) data assurance programme helps improve data quality in the NHS. For the past 5 years they have provided assurance over the quality of the data that underpins payments made under PbR.

In 2011/12 they:

  • Reviewed commissioner arrangements to secure good data quality on the information that underpins PbR
  • Audited inpatient clinical coding and the key data set that supports payment under PbR at every acute NHS trust and foundation trust
  • Followed up recommendations made in previous audits to see how well NHS trusts and foundation trusts have delivered

When considering all trusts as a whole, performance on clinical coding has improved since the PbR assurance framework started, with lower average error rates each year and a smaller gap between the top and bottom of the error range.

They also followed up progress on the recommendations and areas for improvement made in previous reviews. Overall progress was disappointing, with, for example, less than half of trusts completing or making satisfactory progress on recommendations following outpatient data audits.

Consistent good performance is rarer than variable or consistently poor performance, in the report they name the 10 trusts in the best performing category and the 10 in the worst performing category.

They also highlight 5 organisations that have not demonstrated the adequate resolution of issues referred to in the 2010/11 annual report and therefore may still have an incorrect 2010/11 reference costs submission.

This report contains a checklist developed to help, and the Audit Commission’s award-winning National Benchmarker can also be used to check for data discrepancies.

Here are the recommendations from the report:

  • The DH, NHS NCB and Monitor should:
    • Review their approach to assuring PbR costing and payment data in the light of changing responsibilities and developments to PbR
  • Clinical commissioning groups should:
    • Use the checklist provided to improve the quality of data used for payment
    • Require positive assurance that providers are implementing recommendations made at audits
    • Ensure that providers with variable or poor performance demonstrate that data quality is improving
    • Review their approach to ensuring that assurance over the accuracy of data underpinning local payments continues, in light of developments made by the DH, Monitor and the future NHS NCB
  • Acute NHS and foundations trusts providers should:
    • Focus improvement on the accuracy of clinical coding on specialties where data quality is known to be poor, to reduce variation in performance year on year
    • Ensure that reference costs data that underpins tariff setting is accurate
    • Demonstrate to commissioners that they have implemented recommendations accepted at audits


Right data, right payment: Annual report on the Payment by Results data assurance programme 2011/12 (PDF). Audit Commission, 30 Aug 2012.

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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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