NCCQ Administration Process

IHRIM is run by an Executive Board made up of people who work in Informatics fields in the NHS. The Board members all work for IHRIM as well as holding down full time jobs in the NHS. We also employ two part time office staff.


The papers are set by qualified Clinical Coding trainers working for one of the NHS Clinical Coding Academies. The questions are taken from a database of questions updated for each examination in line with current guidelines. The papers are quality assured for accuracy and balance by

Clinical Coding leads (CCLs) from HSCIC, NHS Wales, NHS Scotland and Health & Social Care Services in NI. Alterations are made in line with the findings from this stage and then the papers are submitted to a Quality Assurance Board made up of members from HSCIC, IHRIM and Clinical Coding professionals where they are checked for grammar and clarity. All the Clinical Coding professionals involved in the preparation of the papers have at least 10 years’ experience each in the field.

In the meantime the IHRIM Office staff book the venues, which are visited and assessed for suitability prior to booking, and the staff also engage the invigilators and markers. Invigilators take part in a conference call with IHRIM representatives at which time all the examination rules are gone through and explained. Previous issues are highlighted so that invigilators are aware and can try to ensure that they are not repeated.

Markers are appointed according to strict criteria, which are available on the IHRIM website, but essentially they must have at least 5 years’ experience working in Clinical Coding, have been ACC for at least 2 years and be currently employed by the NHS.

Once the examination has been completed the scripts are returned to the Office and photocopied. They have to be split up for this which is why it is vital that candidates put their number on every page. The scripts are divided into sections and each one is sent to 2 different markers. Only numbers are used to identify candidates to ensure impartiality and this is referred to as “blind marking”. Once the marked scripts are returned to the Office all the marks are entered onto a master spreadsheet. Any differences in the marks awarded for each question are highlighted by the formatting of the spreadsheet. Our marking procedures are very robust and in line with current academic practices.

All scripts and the spreadsheet are then sent to the IHRIM CCL and the Clinical Coding Academy representative. They spend a full week scrutinising any discrepancies between the 2 sets of marks and re-marking any border line fails. A report of this scrutiny and an individual report for each border line fail are generated and sent to an external examiner who is an academic working in the field of Health Informatics. The external examiner’s report and all the documentation are then presented to the Quality Assurance Board. At this meeting any complaints are also considered.

Once the results are verified they are sent out and candidates have 4 weeks to submit an appeal. The Appeals and Complaints Procedure is available on the IHRIM website.

If an appeal meets the criteria then the paperwork is submitted to a convened Appeals Panel chaired by the QA Board Chairman and including representation from HSCIC, a Clinical Coding Academy and the IHRIM CCL.

Their findings are then communicated to the appellants and the examination cycle is complete. At this point any candidate can request a copy of their unmarked script and the papers and answers are posted on the IHRIM and HSCIC websites.

We have received some requests for information on pass rates however we don’t collate pass rates for 2 reasons:

  • IHRIM does not apply a base assessment to candidates so has no control over who takes the exam, unlike academic institutions for example that require a certain level of achievement before students can take their exams. Our advice is that candidates should have worked in the field for at least 2 years before registering for the NCCQ but this is not mandated and candidates could have only been coding for 6 months and not attended any workshops or training. Therefore pass rates are not significant as we don’t know to what level the candidates are working and cannot use the pass rates to make any assessments

  • Some candidates pass one exam at first sitting but resit the other a number of times so the pass rate would depend on what criteria is used making it difficult to identify any trends. We hope this conveys an understanding of how hard IHRIM and HSCIC work to ensure the examination process is fair, equitable and impartial and helps to assure that the NCCQ is run according to high standards. It is unfortunate that occasionally there is an odd mistake that creeps into the papers. No matter how much effort is put into the process human error can occur, as this is a very complex examination to produce.

The NCCQ is not an easy qualification to achieve but it isn’t meant to be. Once Coders are accredited, their employers are assured that they can achieve the high standards of accuracy that are required. IHRIM takes this responsibility very seriously and makes every effort to ensure that the examinations are run on sound academic principles.

If anyone has any suggestions or ideas on how we can improve the examination process or would just like to comment we would be pleased to hear from you.

You can email the IHRIM Office at This email address is being protected from spambots. You need JavaScript enabled to view it.

Lin Snow FHRIM
Director of Education














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