Members of the RCPsych in Scotland express concerns regarding the ongoing implementation of ICD-11 diagnostic coding across Scotland

Scotland news, Statement / comment
13 October 2023

Currently, the implementation of ICD-11 diagnostic coding is placing additional strain on a workforce which is already facing significant pressure. This additional strain risks negatively impacting upon both staff retention and the safety of psychiatric services.

Training is required to support psychiatrists to transition to these standards. Whilst there is training available, this is not always easy to access nor always suitable to the needs of psychiatrists who would require a detailed understanding of the new system. Furthermore, online study alone is not sufficient to allow psychiatrists to agree on how to consistently interpret and communicate the new diagnostic system so that it applies equitably across the country.

It is vital that this training is made more widely accessible to ensure that psychiatrists are sufficiently knowledgeable with regard to ICD-11 diagnostic coding. It is not simply the case of a direct translation from one set of words to another. Inaccurate diagnosis has implications for service efficiency at best and patient safety at worst. A comprehensive training package, systematic iterative training implementation across Scotland and the provision of supporting materials should precede any expectation on clinicians and services to convert to this new system.

Furthermore, the necessary systems are not yet in place to allow the implementation of these standards to be useful. Members have shared with the RCPsych in Scotland that, when giving an ICD-11 diagnosis, this is then translated back to ICD-10 in order to fit the record system used by the Information Services Division.

The RCPsych in Scotland would recommend that there is no obligation put on our members to transfer to ICD-11 until they feel confident in using it. This would require consistent access to appropriate training, an improvement in the current workforce crisis and implementation of necessary recording systems to make the transition meaningful. Meanwhile, clinicians should apply whichever diagnostic classification – either ICD-10 or ICD-11 – they find most clinically helpful in working with their patients.

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