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Department of Health

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National intervention classifications

  • Last modified date:
    9 February 2007

Under Payment by Results hospitals are paid according to the number and complexity of cases treated. The system therefore relies on patient-level data about activity in order to assign the appropriate tariff. The more detail that is captured about the patient's treatment the greater potential for Payment by Results to differentiate different between routine and more complex cases and achieve fairer reimbursement.

For 2006/07 the underpinning classification system (known as OPCS-4.3) has been enhanced:

  • this is the first major update to the system in over 10 years;
  • it is co-ordinated with the ongoing development of casemix classifications (known as Healthcare Resource Groups (HRGs) which involves the input of over 250 clinicians representing Royal Colleges and professional bodies.

Major improvements

The classification system has been expanded by nearly 25% (i.e. to date 1767 additional codes and 216 new categories) for improved coding accuracy.  This gives a better representation of clinical reality and improved information for planning, monitoring and administration.

New inclusions under OPCS-4.3:

  • high-cost drugs
  • specialised services
  • diagnostic radiology
  • chemotherapy
  • interventional radiology
  • radiotherapy

Support for clinical coders

NHS Connecting for Health is providing a range of support for clinical coders and trusts to help implement the new system:

  • self-teach training materials to be used in variety of scenarios to suit local needs
  • classroom training materials for use by accredited trainers as the base for locally delivered training
  • classroom training courses organised by NHS Classification Services from 1 April
  • hard-copy coding reference books supplied free of charge on this occasion to coders in trust
  • training seminars for coding managers and accredited trainers to introduce the key learning points and give support to their planning
  • retained familiarity of coding process and reference materials to help with training and change management while improving both breadth and content
  • terminology mappings will be available from 1st October to support to support Trusts who utilise READ or SNOMED-CT
  • liaison with system suppliers to support trust IT departments make ready for implementation
  • continued support via the NHS Classification Services helpdesk

Continuous development

Ongoing development of the classification system is part of a cycle of continuous improvement throughout both the Payment by Results programme and Connecting for Health initiatives:

  • OPCS-4.3 will be implemented from April 2006
  • 2006/07 review cycle begins for OPCS-4.4 guided by NHS feedback
  • continue with convergence of OPCS and SNOMED-CT
  • enhancement of SNOMED-CT in the medium term

For clinical coding queries and NHS Classification training,  use the existing NHS Classification Service helpdesk contacts:
Tel: 01392 206 248
Fax: 01392 663 839
or

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Contact details for the Department, Connecting for Health and the Information Centre for health and social care; details of advisory groups.

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