Ethnicity Coding in Health RecordsEthnicity Recording in Health and Care Records
Veena Raleigh (The Kings Fund) and Peter Goldblatt (UCL Institute of Health Equity) submitted a paper to NHS England in October 2020 highlighting limitations in both the coverage and quality of ethnicity recording of people using NHS health and care services in England and suggesting how this can be improved.
The paper argues that good quality ethnicity data is essential for improving the health and wellbeing of people from ethnic minority communities. The urgent need for accurate data on the ethnic group of people using health and care services has been graphically demonstrated by the Covid-19 pandemic, which has impacted disproportionately on people from ethnic minority communities.
In welcoming the moves by NHSEI for more comprehensive ethnicity recording in health records, the paper suggests that this should be accompanied by refreshed guidance to ensure that the process of ethnicity recording is compliant with officially approved protocols. The last such guidance on ethnicity coding was issued to the NHS in 2001 (Data Set Change Notice 02/2001 issued by the then NHS Information Authority, since renamed NHS Digital), and is overdue for a refresh. Otherwise the risk is that the well-intentioned and much-needed call for more comprehensive ethnicity recording in NHSEI’s guidance on implementing phase 3 of the response to Covid-19 could result in data that is more complete but the quality of which remains poor.
To this end, the paper recommends that DHSC, NHSEI and NHS Digital take steps to ensure that NHS organisations and staff, and GPs, are aware of how this information should be collected from patients and recorded. For example, the DSCN 2001 made clear that ethnicity should be self-reported, using the official classifications of ethnicity, and that “not stated” is a legitimate response ie patients should have the option of declining to state their ethnicity (which is different to the “unknown” category, where it wasn’t possible to ask the patient their ethnicity). There should also be an agreed set of rules to account for situations in which the patient has a temporary or permanent lack of capacity.
A PDF of the paper can be downloaded from this page.