NHS codes flawed

The NHS Executive was accused of serious shortcomings in theak financial management of a coding project to computerise patient records. financial control of the Read Codes project in a report issued last week by the National Audit Office (NAO).

In the report Sir John Bourn, head of the NAO, said it was essential to the future development of the Read Codes – which are used in electonic patient records – that the Executive commissioned an independent evaluation to confirm the Codes represent value for money.

The Read Codes’ clinical coding system is the central database for national health and medical information, which the NHS Executive has managed since 1990.

Bourn also said the Executive fell below standards set by the Public Accounts Committee on the proper conduct of public business in its handling of the project and he had ‘serious problems in the purchase of the copyright and in the arrangements set up following the purchase’.

The NHS Executive paid Dr James Read, who developed the codes, z1.25m for the copyright in 1990. Exclusive licence and distribution rights for the codes were then granted to Computer Aided Medical Systems (CAMS) Limited, which is owned by Dr Read.

Bourn said Dr Read’s position as centre director meant ‘the Centre had employed him to develop a system in which he had direct financial interest and created a potential conflict of interest for him.’

The report detailed the financial shortcomings of the centre which include the possible loss of #23,000 in computer equipment, a severance payment of #20,000 for an employee who had only worked for three weeks, an unnegotiated payment of #128,000 in lieu to another employee and high fees paid out to unapproved consultants.

The executive refused to comment on the NAO report until the PAC hearing on 23 March but stated it ‘remains fully committed’ to the Codes.

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