Skip to content
Contents

Clinical Coding for 2024

Reference: 24-25471

Date response sent: 30/01/2025

Details of enquiry

  1. How many episodes of care were coded by your organisation in 2024 (both inpatient and outpatient)?
  2. How many episodes of care went uncoded in 2024?
  3. How much income do you estimate was not generated due to uncoded activity?
  4. Can you provide the split of coding volumes between specialities (e.g., oncology, cardiology)?
  5. Please explain how your organisation manages coding activity.
  6. Are outpatient and inpatient coding managed by the same team or separate teams?
  7. How many Whole-Time Equivalent (WTE) staff complete clinical coding for the Trust?
  8. What proportion of the total WTE staff for clinical coding is substantive (permanent), bank staff, and agency staff?
  9. Does the Trust currently have any automated solutions in place for clinical coding?
  10. If yes, please explain the automated solution that is in place.
  11. If not, is the Trust planning to implement automated coding solutions in the next 12–24 months? Or would it be interested in exploring potential solutions?
  12. Is the Trust currently on Payment by Results (PbR), block contracts, or another financial model?
  13. What clinical coding systems or software does the Trust currently use to capture clinical codes?
  14. Does your Trust’s Electronic Patient Record (EPR) system integrate clinical coding, or do clinical departments use standalone systems?
  15. What are the main challenges the Trust faces in clinical coding (e.g., timeliness, accuracy, staffing shortages)?
  16. Could you provide the contact details (name, job title, and email) of the person who is ultimately responsible for overseeing clinical coding within the Trust?

Response sent

Your request for information is not entirely applicable to our Trust, the Tavistock and Portman NHS Foundation Trust as we do not code our patient sessions in the way that acute Trusts would code, and this is explained further below.

The Tavistock and Portman NHS Foundation Trust is a small specialist outpatient mental health Trust, providing mainly psychological services via talking therapies. We do not provide acute services, nor inpatient patient services.

 

  1. How many episodes of care were coded by your organisation in 2024 (both inpatient and outpatient)?

The Tavistock and Portman NHS Foundation Trust only provides outpatient care.

Around 8,400 episodes equating to roughly 700 per month

  1. How many episodes of care went uncoded in 2024?

Nil

  1. How much income do you estimate was not generated due to uncoded activity?

Not applicable – see our response to Q2 above

  1. Can you provide the split of coding volumes between specialities (e.g., oncology, cardiology)?

No.  This question does not apply to our Trust

  1. Please explain how your organisation manages coding activity.
  2. CAMHS (Child and Adolescent Mental Health Services)

We do not diagnose children and do not use clinical coding for this group of patients as our child and adolescent mental health services are delivered in line with the THRIVE Framework for system change, which means that our services are delivered according to need rather than a specific diagnosis. We developed the framework in our services, which takes a no wrong door, population based approach to the delivery of CAMHS. Further information about the THRIVE Framework and the implementation approach can be found here: www.implementingthrive.org.

The Trust uses SNOMED CT, which is a structured clinical vocabulary integrated within our electronic patient record and is not therefore separately inputted. The Trust confirms that your 10 point questionnaire below therefore is not applicable to CAMHS as this department does not undertake the clinical coding to which your questions relate.

  1. AMH (Adult Mental Health Services)

Diagnostic codes do not form part of Trust’s specialist psychoanalytic and psychodynamic based approach to the Trust’s work with adults, so we do not use them within our adult mental health services.

The Trust uses SNOMED CT, which is a structured clinical vocabulary integrated within our electronic patient record and is not therefore separately inputted. The Trust confirms therefore that your 10 point questionnaire below is not applicable to our adults mental health services as this department does not undertake the clinical coding to which your questions relate.

  1. (GIC) Adults Gender Identity Clinic

The (adults) Gender Identity Clinic undertake ICD11 clinical coding. This is not a dedicated activity and forms part of the clinician’s write-up of the patient episode  onto the Trust EPR (Electronic patient record).  The inputting of the coding itself takes just a couple of seconds and is a mandatory action, as our EPR system is set up such that a diagnosis (and its code) must be entered, otherwise it will not save the episode notes.

  1. Are outpatient and inpatient coding managed by the same team or separate teams?

We do not provide inpatient care

  1. How many Whole-Time Equivalent (WTE) staff complete clinical coding for the Trust?

Nil.  See our response to Q5 above.

  1. What proportion of the total WTE staff for clinical coding is substantive (permanent), bank staff, and agency staff?

Not applicable – see our response to Q5 above

  1. Does the Trust currently have any automated solutions in place for clinical coding?

See our response to Q5 above

  1. If yes, please explain the automated solution that is in place.

See our response to Q5 above

  1. If not, is the Trust planning to implement automated coding solutions in the next 12–24 months? Or would it be interested in exploring potential solutions?

We do not hold this data.  FOIA enables access to recorded information held by the Trust at the time the request is submitted.  It does not require an authority to answer questions where this would involve a search to create and provide new information, and this question can only be answered by creating new information

  1. Is the Trust currently on Payment by Results (PbR), block contracts, or another financial model?

No

  1. What clinical coding systems or software does the Trust currently use to capture clinical codes?

See our response to Q5 above

  1. Does your Trust’s Electronic Patient Record (EPR) system integrate clinical coding, or do clinical departments use standalone systems?

Yes, our EPR integrates clinical coding, as described in Q5 above.

  1. What are the main challenges the Trust faces in clinical coding (e.g., timeliness, accuracy, staffing shortages)?

We do not hold this data.  FOIA enables access to recorded information held by the Trust at the time the request is submitted.  It does not require an authority to answer questions where this would involve a search to create and provide new information, and this question can only be answered by creating new information

  1. Could you provide the contact details (name, job title, and email) of the person who is ultimately responsible for overseeing clinical coding within the Trust?

Not applicable. See our response to Q7 above.

Back to top