Service Improvement Plan

Each area of our Service Improvement Plan is listed below along with the specific improvements we intend to deliver.

Click "Read More" to see the progress we've made to date.

Service Improvement Plan commitments which we have now met can be accessed here.

OPCS-4 Standards

We will review all published OPCS-4 standards with users to ensure they are fit for purpose.

Status: In progress

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Progress:

September 2021

  • We are reviewing some of the phrases and language used in the Reference books to standardise the wording and improve consistency, with the aim of reducing user confusion
  • The initial review of the standards to identify any standards which are no longer needed, or need to be updated, started in 2019/20 . This was delayed due to the COVID-19 pandemic. The review will conclude in 2022. We are consulting the NHS Digital National Casemix Office and other relevant stakeholders, including NHS England and NHS Improvement, as necessary before we make any decisions on removal or amendment. Where a standard can be removed if a change is made to the OPCS-4 classification, this will be actioned in OPCS-4.10.
  • Changes to the standards as a result of this work will be actioned initially in the April 2022 reference book, with the work completing in April 2023 with the implementation of OPCS-4.10.

January 2020

  • We will conduct an initial review of the standards during 2019/20 to identify any standards which are no longer needed or need to be updated. We will then consult the NHS Digital National Casemix Office, and other relevant stakeholders, including NHS England and NHS Improvement. Any changes to the standards as a result of this work will be actioned in the OPCS-4 Reference Books in April 2021 and then April 2022, with the work completing in April 2023 with the next (expected) release of OPCS-4.

Training and Audit Frameworks

We plan to publish the framework improvement consultation documents in February 2020 to review feedback during March 2020 to inform redevelopment effective from 01 April 2021.

Status: In progress

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Progress:

September 2021

  • The consultation closed on 30 June 2020 and the feedback was reviewed and published on the Approved Clinical Coding Auditor, Trainer and Clinical Coding Manager workspaces on 11 December 2020.
  • We are currently working with approved clinical coding auditor volunteers on two Auditor Sub-Groups to update the Clinical Coding Audit Methodology and to create an Approved Clinical Coding Auditor Competency Framework.
  • We are also reviewing the feedback to see what changes are required to the Trainer Framework and will convene a Clinical Coding Trainer Sub-Group if required.
  • We are currently still on track to have the updated CCAP and CCTP frameworks in place ready for April 2022.

April 2020

  • The consultation was published on Delen and the Auditor and Trainer workspaces on 30 March 2020 and will close on 30 June 2020. We will be reviewing feedback during July to inform redevelopment for implementation from 01 April 2021 and 01 April 2022.

November 2019

  • We plan to publish the framework consultation document by March 2020 to inform redevelopment from 01 April 2021

June 2019

  • We've gathered lots of feedback from the November 2018 Trainer Forums and March 2019 Auditor Forums and will be looking at ways to strengthen both frameworks to maximise efficiency without compromising their integrity over the next couple of years in line with out Clinical Coding Strategy. Improvements will include:
  • reviewing pass marks for marked assessments
  • considering different levels of auditor and a new level of trainer
  • investigating possible online requirements frameworks
  • reviewing effectiveness of Log Books
  • looking at the skillset required by coding trainers as the healthcare environment changes

ICD-10 will be added to the browser by 31 March 2022. We plan to share information on the user group page about this and will invite users to become involved in testing. We will also publish information about this work on Delen, along with details of plans for the eVersion. We are also investigating options for including a note-taking facility within the browser and will keep users updated on this.

ICD-11 Change Requests

  • We will provide a facility for people to request changes to ICD-11.

Status: In Progress

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Progress:

November 2021

We are investigating the most efficient method for users to submit requests for change to ICD-11. Chapter reviews have now closed.

September 2021

Chapter reviews are ongoing and we plan to use a similar function on Delen for general submissions if this proves successful, or investigate alternatives if not.

Updates about ICD-11 and ICD-10

  • We will publish an update on Delen about the status of ICD-11 and ICD-10, along with future intentions.  We aim to do this by 31 December 2021.   

We will publish updated classifications guidance designed to clarify the process for users. We aim to publish this by 31 October 2021.

Status: Complete

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November 2021

Updated OPCS-4 Requests Submission Guidance has been published on the RSP.

We plan to launch a short survey for all classifications query resolutions by 31 October 2021, seeking feedback about individual resolutions to help us identify areas where we can improve.

Status: Complete

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October 2021

A link to a brief three question survey is included on all classifications query resolutions. We will constantly review the feedback and use it to inform improvements to our service and future query resolutions.

Mapping Quality Assurance Initiative

  • The Mapping Quality Assurance Initiative aims to improve the quality and utility of the SNOMED CT to ICD-10 and OPCS-4 maps. Given the richness of SNOMED CT in comparison to its predecessors v2 and CTV3 and the fact that many of the existing 'legacy' maps were pulled from terms within those deprecated terminologies to SNOMED CT concepts, there is a real need for a focussed quality assurance plan. The work started in April 2019 and will continue for a number of releases to come.

Status: In Progress

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Progress:

September 2021

  • Work on the excessive alternative maps continues. Other recent improvements include the review and update of over 1,000 concepts, including neoplasm ‘disorder’ concepts and concepts within the ‘situation with explicit context’ and ‘event’ hierarchies.

July 2020

  • From April 2019 to July 2020 the classifications mapping team have reviewed and updated, as required, maps for over 2500 SNOMED CT concepts. These quality assurance changes include ongoing work to reduce excessive alternative map targets from legacy maps and assignment of classifications codes not reached in the October 2018 release, to suitable SNOMED CT concepts. Completed work includes streamlining of Map Blocks for Dagger and Asterisk combinations and ensuring appropriate assignment of ‘open’ and ‘closed’ fifth digits or appropriate map advice.
  • A guide to UK Classifications Maps in the NHS Digital SNOMED CT Browser and a significant update of the technical specification and implementation guidance, see SNOMED CT to ICD-10 and OPCS-4 Classification maps - Overview Document, have been provided to support clinical coders and other users of the maps.

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