SUS blasted as 'not fit for purpose'

06 Nov 2007

The Secondary Uses Service (SUS) is not fit for purpose and is failing to provide GP practices and PCTs with the information they need for practice based commissioning (PBC), according to the NHS Alliance.

The criticism of SUS follows the results of the latest quarterly survey of PBC published by the Department of Health last week. The survey of almost 1200 practices, conducted by IPSOS MORI, found that only one in five rated the information provided by their PCT for PBC as good with more than 40% describing it as fairly or very poor.

The survey, which aims to questions a sample of practices in each PCT, also found that more than 50% of respondents described the managerial support they received from their PCT for PBC as poor.

A third of practices reported that they still did not have an indicative budget for PBC, despite PCT returns which show that virtually all practices have been given a budget.

Dr David Jenner, PBC lead for the NHS Alliance, said the quality of information provided for PBC was vital to the success of the scheme.

He added: “A critical issue is information at practice level. The Secondary Uses Service is not fit for purpose in its current form and needs substantial improvement.”

Dr Jenner told EHI Primary Care that data from SUS was only sent to practices four or five months after the date to which it related.

He added: “What we hear from our PCTs is that SUS isn’t timely or accurate and there is not enough information to fully validate claims.”

Dr Jenner claimed that the delay in receiving the data might mean it was months before, for example, a practice was alerted to a sudden rise in emergency admissions. He said Payment By Results meant trusts were also now effectively charging PCTs on a cost per case basis so the ability to easily retrieve information on individual patients was essential.

The NHS Alliance is calling for an audit standard on validation of hospital charges. Dr Jenner said he would like to see data passed from the provider trust to the commissioning trust within a month and for PCTs and practices to have the necessary information to validate that data within two months backed by IT systems that can reliably and rapidly identify individuals.

Dr Jenner added: “Many practices are not getting any data at all and others are getting in very late and it is often incomprehensible and unreliable.”

The DH survey found that most GPs support PBC and one in three has commissioned services as a direct result. The NHS Alliance acknowledged that there had been “some remarkable success stories” with PBC but claimed that the picture was variable around the country and called on the DH to publish the full breakdown of its survey results by PCT and SHA area.

Links

DH survey on PBC

Reader's Comments

No Suprises whatsoever . . .

07 Nov 07 13:14

This report comes as no suprise. The LSP's, suppliers outside of the Programme, GP's, Trusts etc have highlighted the known data quality issues associated with SUS. The double standards with regards data quality are astounding - LSP's and Trusts get continually bombarded by IQAP about the importance of data quality during deployment and yet with the data held on SUS there seems to be no validation of whats contained within. There seems to be a total lack of direction with regards SUS and have to date, in my experience, shown a total disregard to DQ issues or made any attempt to address them.

PBC or GPFH

09 Nov 07 09:30

This sounds disturbingly like people are worried about the wrong problem. Trusts billing on a cost per case basis? I thought PBC was about progressive service change not putting in place a large GP fundholder billing system.

If ensuring bills for admitted patients are received in time is the aim then there is obvioulsy a problem. If the aim is to improve (and invest) in services at primary care / community level to prevent the need for admission then it would appear the focus is at the wrong end of the spectrum. No doubt we're now employing armies of clerks to check the Hospital SUS data.

How can we get away from the electronic paperchase and into service redesign?

Naive or sarcastic?

nhstechie@btinternet.com

09 Nov 07 21:46

"If the aim is to improve (and invest) in services at primary care / community level to prevent the need for admission..."

... and there's me in thinking it was simply a means for commissioners to rip off providers, helping redress the balance for the past 15 years when the opposite applied!

SUS and DQ

11 Nov 07 17:11

If the returns from SUS are as poor in Primary Care from a DQ persepective as they are in Mental Health I'm not surprised there are complaints.

The format of NACs files received from "the Centre" seems to change every month making automated uploads impossible.

CfH provided systems are incapable of loading them monthly anyway and lag about 3 months behind at best (they've only just loaded the first post CPLNHS PCT codes on our iPM system!).

To add insult to injury, we get lambasted by SUS for DQ errors caused by this.

Where duplicates have crept into the SUS database caused by external influence outside the Trust's control, including glitches within SUS, it takes several months to get them removed - meanwhile they reflect badly on our MMHDS scores ... on which my team is performance managed by the PCT!

No wonder PbR is in such a mess with millions in dispute between some Acute Trusts and their PCTs!

As Derek and Clive used to say "is this the way to run a ......?"