The Health Board has made some progress since our last follow-up review, but many long-standing issues remain.

Workforce stability within the Clinical Coding Team has improved supported by clearer management arrangements and staff development opportunities. Staff also report a supportive team culture. However, significant senior vacancies remain, and key activities such as validation, audit and training still depend on a small number of individuals. The Clinical Coding Policy and Procedure Manual is outdated and no longer reflects current operational arrangements.

Medical records continue to be a major barrier to timely and accurate clinical coding. Although the use of temporary records has reduced and access has improved in some areas, problems persist with record quality, delays in collation, inconsistent tracking and continued reliance on paper records.

Board awareness of clinical coding has been maintained and there is a commitment to improvement. However, oversight is limited with reporting focusing narrowly on Welsh Government targets. There is little explanation of the use of coded data and committee oversight is unclear. While the Clinical Coding Team’s visibility has improved, clinical engagement remains limited.

The Health Board’s performance against Welsh Government clinical coding measures and targets has not shown sustained improvement and continues to fluctuate over time. While a range of actions are underway, there is no clear, coordinated plan to drive and sustain long-term improvement.