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Coding clinical work should allow accurate and precise methods of assessing individual or department activity. The NHS financial reforms have increased correct diagnostic coding importance by introducing “payment by results” so that funding is directly linked to patient activity. The aim of this study is to assess the accuracy of procedure codes (OPCS 4.4), and its effect on Healthcare Resource Group tariff codes that directly affect revenue.

A total of ten procedures from ten consultants were randomly selected over one month. Each consultant coded his or her own procedures. From these codes, Healthcare Resource Group tariff codes were assigned to each patient. These were compared with procedure and Healthcare Resource Group tariff codes generated by coding department staff.

Of 100 procedures, four were un‐coded by coding department staff. There was concordance in 35 per cent of cases. Coders only gave one code for each procedure, whereas 35 per cent of procedures coded by consultants were assigned multiple codes. This resulted in 27 per cent of cases generating a different Healthcare Resource Group tariff code. Of the cases, five resulted in a difference of £4,000 or more; however, the overall difference was a £3,367 revenue loss if coder's codes were used.

Study numbers were limited to 100 with five cases showing excessive financial gain or loss significantly influencing the overall result.

Present procedure coding practice is inaccurate and results in Healthcare Resource Group tariff codes that do not accurately represent clinical activity and productivity. Under payment by results, this can result in a significant revenue loss and possibly ultimately future referrals. Therefore, coding practice needs to be improved as a matter of urgency. Arguably, this could be achieved by closer communication between coders and clinicians.

The paper identifies a flaw in the way clinical activity and productivity is assessed at present. This is fundamental to the process on which “payment by results” is based, and therefore must be addressed if trusts are to be financially successful.

This paper aims to offer empirical evidence about the effect of the interaction between the audit committee and the internal audit function (IAF) on the moral courage of the chief audit executive (CAE).

A mixed approach was followed. In the first stage, questionnaires were sent to CAEs of 60 listed, financial and non-financial Tunisian companies. To enhance the depth of the analysis, in the second stage, semi-directed interviews with 22 CAEs from listed financial and non-financial Tunisian companies were performed.

This paper found that the existence of private access to the audit committee has a positive effect on the moral courage of the CAE. The number of meetings between the audit committee and the CAE, the examination of internal audit programmes and results together with the contribution of the audit committee to the appointment and dismissal of the CAE do not show a significant link with the moral courage of the CAE. It also found an insignificant relationship between the audit committee’s examination of interaction between management and the IAF and the moral courage of the CAE.

To the best of the authors' knowledge, this paper fills one of the major research gaps in the auditing literature by demonstrating the critical role of audit committee–internal audit interaction in promoting the CAE’s moral courage to behave ethically.

This study aims to identify the political alignment and political activity of the 11 Presidents of Britain’s most important scientific organisation, the Royal Society of London, in its early years 1662–1703, to determine whether or not the institution was politically aligned.

There is almost no information addressing the political alignment of the Royal Society or its Presidents available in the institution’s archives, or in the writings of historians specialising in its administration. Even reliable biographical sources, such as the Oxford Dictionary of National Biography provide very limited information. However, as 10 Presidents were elected Member of Parliament (MP), The History of Parliament: British Political, Social and Local History provides a wealth of accurate, in-depth data, revealing the alignment of both.

All Presidents held senior government offices, the first was a Royalist aristocrat; of the remaining 10, 8 were Royalist or Tory MPs, 2 of whom were falsely imprisoned by the House of Commons, 2 were Whig MPs, while 4 were elevated to the Lords. The institution was Royalist aligned 1662–1680, Tory aligned 1680–1695 and Whig aligned 1695–1703, which reflects changes in Parliament and State.

This study establishes that the early Royal Society was not an apolitical institution and that the political alignment of Presidents and institution continued in later eras. Furthermore, it demonstrates how the election or appointment of an organisation’s most senior officer can be used to signal its political alignment with government and other organisations to serve various ends.

The history of the Encyclopaedia Britannica from its inauguration in 1768 up to the ninth edition of 1888 is described. Its origins in Edinburgh during the Enlightenment are discussed and its early Edinburgh editors and contributors reviewed. Later editors and contributors and the gradual changing of the work are discussed. Its expansion from an Edinburgh to a global publication is also demonstrated.

The purpose of this paper is to explore the clinical implications of the case of AM and the ruling that the Mental Health Act no longer has primacy over other legislation in certain treatment situations.

Critical case analysis and discussion.

The Mental Capacity Act Deprivation of Liberty Safeguards could be used more widely, and in preference to the Mental Health Act, but this may cause problems to clinicians and other decision makers such as Mental Health Tribunals.

This case and its findings have not been widely discussed in academic or clinical practice literature.

Accrediting agencies come in two sizes, the large regional associations that determine academic standards throughout the United States such as the Western Association of Schools and Colleges or North Central Association of Colleges and Schools, and smaller specialized agencies that determine specific criteria for academic programs such as Accrediting Bureau of Engineering Technology (ABET) or American Psychological Association (APA). On the surface, both types of accreditation are voluntary. However, essentials in the world of academia, such as government, state and local funding, are dependent on, at a minimum, regional accreditation. Thus, regional accreditation is sought by all. In the current world of tight funding, however, the role of specialized accreditation is taking on significance even though it plays a different, but similar role.

In its passage through the Grand Committee the Food Bill is being amended in a number of important particulars, and it is in the highest degree satisfactory that so much interest has been taken in the measure by members on both sides of the House as to lead to full and free discussion. Sir Charles Cameron, Mr. Kearley, Mr. Strachey, and other members have rendered excellent service by the introduction of various amendments; and Sir Charles Cameron is especially to be congratulated upon the success which has attended his efforts to induce the Committee to accept a number of alterations the wisdom of which cannot be doubted. The provision whereby local authorities will be compelled to appoint Public Analysts, and compelled to put the Acts in force in a proper manner, and the requirement that analysts shall furnish proofs of competence of a satisfactory character to the Local Government Board, will, it cannot be doubted, be productive of good results. The fact that the Local Government Board is to be given joint authority with the Board of Agriculture in insuring that the Acts are enforced is also an amendment of considerable importance, while other amendments upon what may perhaps be regarded as secondary points unquestionably trend in the right direction. It is, however, a matter for regret that the Government have not seen their way to introduce a decisive provision with regard to the use of preservatives, or to accept an effective amendment on this point. Under existing circumstances it should be plain that the right course to follow in regard to preservatives is to insist on full and adequate disclosure of their presence and of the amounts in which they are present. It is also a matter for regret that the Government have declined to give effect to the recommendation of the Food Products Committee as to the formation of an independent and representative Court of Reference. It is true that the Board of Agriculture are to make regulations in reference to standards, after consultation with experts or such inquiry as they think fit, and that such inquiries as the Board may make will be in the nature of consultations of some kind with a committee to be appointed by the Board. There is little doubt, however, that such a committee would probably be controlled by the Somerset House Department; and as we have already pointed out, however conscientious the personnel of this Department may be—and its conscientiousness cannot be doubted—it is not desirable in the public interest that any single purely analytical institution should exercise a controlling influence in the administration of the Acts. What is required is a Court of Reference which shall be so constituted as to command the confidence of the traders who are affected by the law as well as of all those who are concerned in its application. Further comment upon the proposed legislation must be reserved until the amended Bill is laid before the House.