Clinical News

Hepatitis in prisons

Friday, 22 July 2011 09:45

The Health Protection Agency and Offender Health produce a quarterly bulletin called 'Infection Inside' which looks at current topics regarding health protection in prisons. The current issue focuses on hepatitis to mark World Hepatitis Day on 28 July. Hepatitis affects a large percentage of the prison population and Dr Martin Lombard DH Clinical Director for Liver Disease says that 'During the course of developing a strategy for liver disease, it has become apparent that a significant proportion of people in correctional institutions may be unaware that they are at risk of developing liver disease. Data from a variety of developed countries (including England, Scotland and Ireland) shows overall HCV seroprevalence rates in correctional facilities ranging from 20-40%, with much higher rates in those prisoners with a history of IDU: data compiled by the HPA indicate that approximately 26% of prisoners were tested in 2009 and 22% of those were positive'.

For further information about work carried out by Offender Health and the Health Protection Agency in prisons see . The full version of the current bulletin ‘Infection Inside’ can be accessed below.

Clinical Audit Learning Packages on HQIP website

Monday, 11 July 2011 13:33

6 July 2011: HQIP has launched a dedicated online learning area of its website, designed to offer a range of free-to-use clinical audit learning packages with specific themes and/or audiences. Please visit

Payment by Results – 2011 Update

Thursday, 07 July 2011 10:53

Tim Heymann and Geoff Sandle - BSG Information Group

Payment by Results (PbR) describes the way in which hospitals are paid for what they do. The system was introduced for a limited number of hospital services in 2005/06 with the aim of providing a transparent, rules-based system for paying providers. Since then the scope of PbR has increase to cover approximately 70% of hospital services. In theory it should reward efficiency, support patient choice and diversity and encourage activity for sustainable waiting time reductions. Payments are linked to activity and adjusted for casemix. One ambition has been to ensure a fair and consistent basis for hospital funding.

Payments are linked to the HRG (Healthcare Resource Group) derived for each patient's time in hospital (the period from admission to discharge) , the resources that they need and use such as staff time, bed days and consumables. Broadly the PbR tariff reflects the actual costs of each HRG. Those costs are calculated from the national average reference costs which every NHS provider submits. The tariff can then be adjusted at Department of Health (DH) discretion each year, for instance to encourage efficiency. This year tariffs have been set at 1% below the last year's mean reference costs. They have been adjusted to promote new ways of working: for instance the PbR tariff is set at zero for patients who are readmitted within 30 days of discharge following an elective admission. That is meant to encourage safe, appropriate discharge and the development of “re-enablement” services in the community. Tariffs are also adjusted to acknowledge unavoidable differences in operating costs in different parts of the country, so are higher for care in central London hospitals than in provincial centres such as Truro. Supra regional services such as transplants, and some specialist treatments e.g. chemotherapy, specialist rehabilitation and high cost drugs do not currently have mandatory national tariffs and are left for local negotiation.

Clinical Coding - An Update

Tuesday, 02 November 2010 16:24

CCSD has informed us about the following new or updated codes and narratives for use in private practice:

M2981 Endoscopic anti-reflux procedure (and bilateral) (including cystoscopy)
H2502 Diagnostic flexible sigmoidoscopy, including forceps biopsy and proctoscopy

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