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In 2016 hospital budgets were separated into activity-based funding (ABF) and non-ABF (eg, pay costs) budgets for the first time by the HSE.
ABF activity targets and fixed ABF budgets for inpatient and day case work were set, which rely on [Hospital inpatient Enquiry] HiPE coding to accurately reflect the patient activity taking place in the hospital.
However, according to a report on ABF delivered to the GUH hospital management team meeting in May, the minutes of which were seen by MI, there have been 17,000 uncoded HiPE cases in the hospital.
The meeting heard that €800,000 has been “lost this year owing to inaccurate/incomplete coding”.
Issues regarding clinical chart quality and poor audit quality following review were highlighted.
The importance of hiring a HiPE manager and additional HiPE coders was stressed to attendees.
During the GUH management meeting in June, it was stated that only whole-time equivalent (WTE) staffing increases related to risk issues would be considered in future and all non-discretionary spending must cease and further cost savings were required.
“Additional cost pressures will be incurred locally as a result of ward moves, cleaning, reconfiguration, etc,” according to the minutes.
Speaking to MI earlier this year, HSE Assistant Chief Financial Officer Ms Maureen Cronin said ABF is still very much in an “embryonic phase”, despite the fact that the majority of hospital funding is now based on the model.
“It is a multi-year programme,” Ms Cronin said.
“It is going to take a number of years to fully implement. It is going to take some time for us to feel satisfied that the coding of the clinical data and all costing is correct. In that sense we are in an embryonic phase, which is the best way to describe it.”