NHS Data – which one are you, again?

© Matthew Collingwood Dreamstime.com

Last week’s news that the NHS has saved £6.1 million by removing about 95,000 ‘ghost patients’ from its GP lists sounds impressive, but it only exposes the tip of the iceberg.  Removing these outdated records from GP lists is a step in the right direction, but there are other pressing reasons why a concentrated clean-up of patient data is needed.

The quality of data supporting the NHS has been poorly controlled for years and now that healthcare information is beginning to be shared between care providers the true extent of the issue is set to be highlighted.   With NHS Trusts under relentless pressure to measure and publish quality outcome indicators and with the increased accountability that directly affects their budgets the need for clean, accurate and accessible data is more important than ever.

To enable health care providers to identify which patients they are actually treating the NHS maintains its Personal Demographics Service (PDS).  The PDS is where data on every recorded NHS patient is held; it’s used by hospitals and other care-providers as the most up-to-date repository of patient identity available.  However, matching the details a patient has given about who they are against the hospitals own database and then verifying with PDS is not always straight forward.

If patient A is recorded in one database as living on ‘Salisbury Road’, and on another database as living on ‘Salisbury Rd’ then to a computer you have a failed match and there is an error, whereas to a human user the records are clearly the same and perfectly usable.  However, where the flow of information is electronic, and interpretation performed by computers the situation becomes very much more polarised and a minor error can lead to the failure of the referral mechanism, resulting in a patient being unable to book treatment, or to unknowingly receive treatment under a separate identity.  Such situations are often propagated as treatment staff, having recognised registration problems, will often not have the authorisation to make the changes needed.

It is not surprising then that A&E departments find themselves treating unknown or non-NHS patients which results in the hospital not being able to claim back the cost from the Department of Health.  As part of the NHS Reforms hospitals will become reliant on their own income to fund treatment.  Without being able to verify who they are treating, hospitals will lose out to “ghost patients” and “health tourists” meaning they won’t be paid and won’t have the cash available to maintain their service levels. It is vital to address wider data quality issues now, before the Reform Bill changes the NHS beyond recognition.

2 thoughts on “NHS Data – which one are you, again?

  1. The document is a study in sbdounites and misdirection. The demonisation of an entire profession in Working Together for a Stronger NHS’ is both unjustified and offensive. Many managers in the NHS are highly qualified professionals in multiple business disciplines. Managers have jumped to the tune of successive governments implementing half baked polictical and beurocratic backside covering idea’s beacuse they’ve had to not because they agreed. As a country we can’t afford the NHS with year on year rising demand we get it we are not stupid. However, there won’t be any listening’ to how we could tackle this without destroying the best of what the NHS has to offer and there won’t be any meaningful debate with the country about that because it’s far easier to blame managers and transfer the responsibility to Doctors then politicians can blame them. Lansley reforms will not deliver anything but more cost and then more beurocracy to try and stem that rising cost.

  2. This leaflet is bltanat propoganda is this even allowed under the rules of purdah? Where is the evidence that that dismantling one buraucracy and spending millions on building another will address the issues identified? Where is the evidence that targets have been terrible for patient care when everyone agrees that the NHS has never been in a better state? And if hospital doctors need their time freeing up to focus on patients, why should GPs have to spend all their time on buraucary instead? Who will train the extra GPs required if doctor time is spent running a health system?The reforms will not give more power to the patient, just more power to consortia, patients already have choice.Take away the purchaser provider split and have primary and secondary care working collaboratively, take away artificial market mechanisms then you’d really cut buraucary. Are you really going to allow hospitals to go bust? Even the private sector aren’t going to be keen to snap up struggling organisations with huge PFI debts round their neck.Change may be needed, but not this change.

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