Impact of sepsis coding changes is the first in our series of briefings for the NHS

Dr Foster has undertaken an analysis of sepsis spells to ascertain the impact of national sepsis coding guidelines and to track variation in sepsis coding practices across trusts in England.

This briefing for medical directors is the first in a series of briefings for healthcare professionals and managers by Dr Foster aiming to shine a spotlight on important data issues and highlight actions that could be taken to address them.

This analysis revealed a significant spike in the proportion of episodes coded with sepsis in the primary position in April 2017 and a decline from April 2018, following changes to the national guidelines in each year. The briefing examines the causes of these fluctuations as well as changes to the importance of clinical terminology and judgement.

The briefing also examines inconsistency in coding practice across trusts and looks at why this may be occurring. It illustrates the importance of a universal coding practice and why a review of sepsis coding at trust level will be critical in ensuring the quality and accuracy of remuneration, mortality ratios, and risk assessment going forward.