article banner

Healthcare assurance

Accurate clinical data and cost information is vital so that healthcare services, performance and payments accurately reflect the patient care being delivered. This promotes understanding, transparency and trust between commissioners and providers.

Our industry leading healthcare assurance team works with national and local healthcare bodies to improve the quality of data and the accuracy of contracts and payments. We have worked with the NHS and private providers for over 10 years to support the effective implementation of the payment system.

Our team consists of specialist managers with a background in audit, clinical coding, and contracting and information departments. They provide independent, credible reviews that deliver real and sustainable improvements.

We use that knowledge to support contracting arrangements in health economies. This helps to increase the trust and transparency between providers, commissioners and regulators and supports health economies to resolve system issues relating to the cost of care within tightening financial constraints. Overall system sustainability is dependent on ensuring that organisations are appropriately reimbursed for services they provide, and that services are managed effectively based on accurate clinical cost and activity data.

The benefits of working with us include:

  • Assurance -the assurance programmes we develop ensure that patient information is coded, recorded, classified and reported in line with national guidance and local expectations.
  • Independent and authoritative view – we assure boards, commissioners and regulators that contracts, payments and cost information accurately reflects the care delivered.
  • Experience - we work across the healthcare sector with regulators, commissioners, acute trusts, mental health and community providers, as well as independent healthcare providers.
  • Proven methodologies - our analytically driven, bottom-up approaches review of patient records examines all data items that inform payment, not just clinical coding, using a flexible approach to follow through on issues identified.
  • Identifying root causes - we engage directly with clinicians and service leads to ensure clinical buy-in to our findings, and identify the underlying causes of incorrect data, in order to produce detailed recommendations for improvement that result in real change.
  • Expertise - the team previously managed and delivered the Payment by Results data assurance framework on behalf of the Audit Commission, the Department of Health and Monitor (now NHS Improvement). It has delivered over 2,000 audits at every acute trust in the country, assessing over £350 million of payments.
  • Benefits beyond payment - improving contracting data will also improve the data that underpins service management and redesign and the monitoring of clinical quality. The same data is used in the Get It Right First Time (GIRFT) programme, the model hospital and SHMI mortality indicators.

Peter Saunders

+44 (0)20 7865 2158

Find out more