P093 Accuracy of Model Health System compared with clinician logbook data: a validation study

Abstract

Model Health System (MHS) was commissioned by NHS England in 2014 as a ‘data-driven performance tool that enables Trusts to benchmark quality and productivity’. Programmes such as ‘Getting It Right First Time’ utilize MHS data to review specialties and use ‘data-driven evidence to support change’. MHS uses procedural OPCS-10 and diagnostic ICD-10 codes. These cannot take clinical context into account and consultants are therefore encouraged to review their own data. We analysed MHS data from July 2023 until June 2025 and compared them to a contemporaneous electronic logbook kept by a locum consultant dermatologist undergoing Portfolio Pathway training to determine the accuracy of the coded entries. MHS records the total numbers of procedures carried out; elective or day-case readmissions within 30 days of discharge in a related specialty; all-cause emergency readmissions and readmission with infection or sepsis. We reviewed electronic notes when required for further information. In total, 1554 patients had a recorded head and neck or body lesion excision on MHS; however, only 633 (40.7%) had been operated on by the named clinician. Thirty related elective admissions were recorded on MHS. Of these, only 17 appeared in the logbook. Thirteen had an alternative lesion removed in dermatology; one returned for delayed reconstruction and three were seen for an ophthalmic condition. Ten patients were recorded on MHS as emergency readmissions. These emergencies included bowel obstruction, pneumonia and sepsis and were unrelated to the original excision. We found MHS data to be highly inaccurate when compared with raw data. The overall numbers were hugely inflated, which may be due to other healthcare professionals operating under the consultant’s code. More concerning were the recorded complications and readmissions. Of 43 recorded patients, only 22 (51%) appeared in the logbook and none of these had a complication or readmission related to their procedure.