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Clinical Coding in 2020 and what next in 2021

Clinical Coding in 2020 and what next in 2021

Clinical Coding – the analysis of clinical statements and the assigning of alpha numeric codes from a classification system. The job we all love, breathe is a curious career. One that often flies under the radar but is integral to health informatics. But what is the state of the landscape in an industry that rarely gets the plaudits it deserves in a year that has seen the most unique circumstances?

At the start of the year it was business as usual across the UK. Coding departments were working like clockwork, running to deadline and working from home was a pipedream. But withing the space of a few months this was all about to change…. The global pandemic hit and the way we lived our working lives was turned upside down.

This had profound impact on the coding industry. Offices where everyone was previously crammed into the smallest of office spaces, now had to work from home. The source documentation that had previously been touched by everyone within the hospital was now a potentially health risk. The task of moving everyone remotely, which had previously seemed impossible, was done with the strategic maneuverer of a military operation. It makes you think – if it was this easy why wasn’t this feasible before?

Coding managers have reported increased productivity, less sickness and an increase in morale for those that need the flexible working (like me, those who have young children will understand). The move to open up the coding industry as a remote service has enabled NHS coding managers to widen the net. Just take a look at NHS Jobs now. There are coding opportunities all over the UK with the disclaimer ‘Please note that due to the pandemic we are currently working remotely’. This not only gives coders across the UK so much more options but opens up trusts (which had previously been restricted to their own geographical area) to previously unobtainable high calibre coders. This is nothing against trainee coders, who are essential to keep the industry going (that discussion is for another time) but the choice between an ACC experienced coder, who can hit the ground running or a trainee who needs constant support in the current climate is a no-brainer.

The major impact to the industry and NHS as a whole however didn’t come from NHS managers but from NHS Chief Executive Simon Stevens and NHS Chief operating officer Amanda Pritchard on 17th March 2020. A publication to all NHS chief executives following the initial paper stated that due to the pandemic and in an attempt to reduce expose to patients and those most at risk all NHS trust were to be placed on block contacts for the period April-July 2020. This then moved to March 2021 given the recent rise in infection rates. But what did this mean for coding?

PbR is now a distant memory and it’s hard to foresee any NHS moving back from its current status. Why would they? Has this led to trusts now losing interest in the financial implications for coding? Has the importance we once had diminished? These are all questions I can’t answer – and suspect only the CCG’s can. Has coding been demoted to a data input role for the production of data warehousing, trend analysis? It’s certainly shifted the spotlight away from our profession.

What about the talk of auto coding, SNOMED? This has been spoken about since the days when I started as a trainee over a decade ago, and it’s still ongoing. With trusts now having full EPR’s or ‘paper light’ systems how do we get to that space where even very simple mapping of terminology to classification codes comes to fruition? There’s lots of work to be done and to establish this in the correct systems, ensure that their being used appropriately. We’d like to think that clinicians will enter the right terminology & record the information to the level on granularity needed for reporting & information standards. But there’s still lots of education needed to be done with clinical workforces around the use of terminology & the importance of the role they play. THAT is where coding comes in.

In terms of the future…coding is heading in the right direction to help set up robust reporting and clinical systems, but are we going to get there in the next five or ten years?

It’s a very gradual process, dependant on a much larger national strategy to get systems like SNOMED out there & implemented across multiple providers. But with the unique skill set

that clinical coding brings it’s fully equipped to cope with whatever the future or 2020 throws at it.


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October 20, 2020

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