Q&A – Clinical Priority Coding

Question

Do you offer any advice on clinical priority coding. I work in a couple of practices (now health board run) where admin have started coding, something I approve of.  However, I have noticed that everything is being coded as priority 1 – such as minor animal bites, sprain ankles, dry eyes etc – the list is endless.

I had always thought the priority system was useful – from a governance point of view it means clinicians can easily weed out the insignificant diagnosis from those which are long term/enduring/significant to a patient’s long term health.  We use priority 1 as the only information which goes to secondary care on the referral letters.

I fear that this approach is going to leave a significant risk of missing a significant diagnosis in amongst all that which is historical and of no or lesser long term importance to the long term health of a patient.

I am not sure what is happening in other areas and whether this approach is now ubiquitous – but as far as I can see there seems to be no concensus on what should be priority 1, so everything is now priority 1.

I would appreciate if you have done any work on this, or discussed this , that it could be shared.

many thanks

Jason Twinn

GP, Tayside

Answer:

Dear Dr Jason Twinn,

Many thanks for your email, SCIMP indeed do offer guidance about priority coding for data.

Generally high priority data (in Vision coded as priority 1) should be shared on referrals, nationally by default these are auto-populated on SCI-Gateway referrals.  In health boards that have a Clinical Portal systems these important codes are shared.  SCIMP agree with the desire that pertinent information is shared which is not diluted with “insignificant diagnosis from those which are long term/enduring/significant to a patient’s long term health” as you mention. 

Dr Beena Raschkes Joint eHealth Clinical Lead, NHS Tayside and SCIMP WG member has kindly sent you directly a suggested Priority Code 1 list and a more detailed explanation about the background of this in Tayside. 

SCIMP have recently updated a code list subset with recommended codes for practices to use when coding data.   Following user feedback we are in the process of robustly updating this suggesting which codes should be shared.

Kind regards

Dr Chris Weatherburn

Interim SCIMP Chair

GP