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Practices responsible for maintaining ethnicity coding improvements under new standard

by Jess Hacker
6 December 2021

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General practices will be responsible for routinely monitoring the quality of their ethnicity coding, the DHSC has said.

It comes after it confirmed it is producing a new information standard to improve how the information is recorded in GP patient records and health datasets.

In its final report on how it intends to address Covid-19 health inequalities (3 December), the DHSC said that improving the recording and coding of the ethnicity of patients in health records was ‘the highest priority’.

Currently, issues with ethnicity coding disproportionately affect ethnic minority patients’ records.

The new information standard will include up-to-date guidance on ethnicity coding for GPs and other health service providers.

It is set to cover how patients should be asked for their ethnicity and how practice staff record this in their health records.

Additionally, practices will be expected to ‘take ownership of the quality of ethnicity coding’ for their patients.

This would include routinely monitoring their coding quality, identifying how it can be improved, and taking action to achieve this.

The DHSC said that by improving how it is collected, policymakers and researcher would gain a ‘better understanding’ of the health impacts on people from different ethnic groups.

Data collection quality varies by CCG

It comes after NHS Digital data revealed that the proportion of records that have been coded with an ethnic group can vary between different areas.

The dataset – which was cited in the DHSC report – showed that across the 106 CCGs, ethnicity was reported for 93.6% of patients.

But while NHS Knowsley had the highest coverage at 98.4%, ethnicity reporting in NHS Bury sat at just 82.6%: a difference of 15.8%.

Despite being the CCG with the highest number of patients with a known ethnicity, NHS North West London was among the 10 CCGs with the lowest level of ethnicity coverage (90.1%).

Meanwhile, out of the 10 CCGs with the highest proportion of patients with a known ethnic category, six were located in the North West of England.

It flagged, however, that higher rates of recording of ethnicity ‘do not necessarily’ mean better quality data.

‘Unacceptably disappointing’ report

The BMA welcomed the improvements to tackling health disparities, however, it stated that it found the report ‘unacceptably disappointing’ for failing to address the impact Covid has had on NHS staff from ethnic minority communities.

The report identified that one of the main factors behind the higher risk of Covid infection for those from ethnic minority backgrounds was occupation, particularly for those in frontline roles, such as NHS workers.

It also called on at risk groups to get booster jabs and identified the vaccine programme as the most significant means of protecting people from ethnic minority backgrounds from Covid.

‘It is therefore beyond reason as to why it only briefly refers to the NHS workforce and fails to even reference the disproportionate Covid mortality rate for ethnic minority doctors,’ Dr Chaand Nagpaul, BMA council chair, said.

He added that the Association has ‘consistently’ called on the Government to investigate the reasons behind the disproportionate mortality rate.

‘By ignoring this without addressing this crucial issue, the report fails to address a major inequality facing the NHS workforce.’

It comes after a report published last month found that inequality among the NHS workforce is ‘getting worse’ and is standing in the way of its ability to find and retain staff.

Earlier this year, the Government’s report on race and ethnic disparities was similarly criticised for providing ‘shockingly little analysis’ on the challenges faced by ethnic minority doctors.