Ardens-QMasters

MH002 Mental Health Care Plan Reviews for QOF

21/1/2019

Some practices have reported that their Mental Health Care Plans and Reviews appear not to be 'counting' under the EMIS QOF Population searches using the v39 QOF Rules.

There are a number of codes which were previously valid under the business rules which have been removed from v39, leaving just three. Version 41 of the rules, on which this year's payment will be based, contains ten such codes. The below table shows a comparison.

We have reviewed the QMasters MH Template and checked the cross mapping of all the codes relevant to MH002. A summary of the findings is below:

The three highlighted codes have been in use in the QMasters Mental Health Template for the 2018-19 QOF year but are no longer in the allowed codes for the business rules under v39 or v41.

We will shortly be updating our customers with a new version of the template with these obsolete codes removed from the relevant picking list. The current template still contains the other codes, which may be used and are still within the business rules.

Meantime, practices may wish to download and run the following search which will identify patients with the wrong codes and allow these to be changed prior to year end.

To download this search folder and instructions for use, please click here.

Cervical smear codes and QOF business rules

17/1/2019

Changes to the QOF business rules and the introduction of SNOMED-CT coding have resulted in some changes to the way in which cervical smears are coded. This post explains the changes and what action you may wish to take as a result.

The following information on cervical smear codes was recently shared by NHS England:

Re: QOF 2018/19 – Cervical Screening

This message is for information relating to QOF 2018/19.

It has been brought to our attention that some practices might be using Read and CTV3 code 685.. ‘Cervical neoplasia screening’ as an administrative code or problem heading to manage cervical screening recalls.
This Read/CTV3 code’ 685..’ was not included in the code cluster SMEAR _COD for QOFv38 (Payment QOF2017-18).

The Read and CTV3 code 685.. ‘Cervical neoplasia screening’ is in the preventative procedures chapter and has been mapped to the SNOMED term 171149006 ‘Screening for malignant neoplasm of cervix’ which is in the cancer screening hierarchy in SNOMED. There are some other Read and CTV3 codes that also map to SNOMED code171149006. The table below shows Read/CTV3 codes that are mapped to SNOMED code 171149006 ‘Screening for malignant neoplasm of cervix’.

We have consulted with our terminology team and clinical advisors and asked for the mapping to be reviewed, and it was agreed that these maps are appropriate. The methodology to undertake the mapping from Read and CTV3 to SNOMED, plus an extensive quality assurance process, has been overseen by a number of national GP clinical leads and terminology experts and validated by the Joint GP IT Committee. The mapping tables have been signed off as clinically safe for the transition of historical data.

On this basis 171149006 ‘Screening for malignant neoplasm of cervix’’ has been included in the cluster SMEAR_COD for QOF v41 (Payment QOF 2018-19). The effect of this is that records with 685.. ‘Cervical neoplasia screening’ will now be reported for QOF v41. If the QOF cluster is used to support cervical smear recall then patients who have a record where 685.. has been used as an administrative code may appear to have had a smear and could be missed from smear recall.

We would therefore request that practices check for this code in their records so that if they are using it for administrative purposes, rather than to show the smear has taken place, then they will need to update their records for the end of year. The SNOMED code 714971000000104 | Cervical smear screening administration | which is a ‘heading’ code could be used instead.

Whilst the QMasters Cervical Smear template does not use the '685' code, it does use some of the child codes, so we have chosen to undertake a review of all of the 685.. codes used in our smear template.

The detailed breakdown of the findings are shown in the table below: all except 2 of the codes are legitimate for use under the current (v39) business rules and all of them are legitimate for use in the v41 business rules, on which end of year payment will be based.

What does this mean for QMasters customers?

For users of QMasters templates, it means that entries of the codes 685L or 6856 via the Cervical Smear template may not be recognised by the current v39 release of the QOF searches so may show patients still needing a smear when they have in fact declined (685L) or had a smear (6856).

These codes are, however, still appropriate to use under the v41 rules which should be applied in February. These will be the rules used for payment at QOF year-end. We do not therefore recommend any change in practice.

What does this mean for users who are not QMasters customers?

If you use your own templates, or enter codes manually, you need to ensure your practice has not been using the 685 code (cervical neoplasia screening) as an administrative code, as it may appear that these patients have actually had a smear when they have not, and hence be removed from the recall lists.

If you have been using a 685 code in this way, you may want to run a search for all patients with a 685 code without another, definite, smear procedure code and ensure there are not a cohort who have been inappropriately removed from the recall list.

DEM004 Dementia review coding for QOF

17/1/2019

There have been some queries from practices around the DEM004 indicator and the required codes for inclusion.

Patients who have had a Dementia Care Plan agreed or reviewed at a face-to-face encounter in the year should be included in the DEM004 'included' population. However, patients who have been coded with 8CMZ - Dementia care plan or 8CSA - Dementia advance care plan agreed will currently be showing as 'excluded' according the v39 searches in EMIS Web.

This has been queried with EMIS Health, who replied as follows:

"...the code 8CSA was not included in the version 39 business rules. It has been re added by NHS Digital in the version 41 business rules which should be published and added into EMIS shortly (we have not been provided with an exact date as of yet.)"

The draft version of the v41 rules also includes the SNOMED-CT code 1095121000000102 which maps to the READ code 8CSA. Click here to view the draft v41 business rules.

Therefore, it appears you can continue to record these codes as dementia care plans but until your practice is updated with the v41 business rules searches, these patients will mistakenly show as 'excluded' in your Population Reporting dashboard.

Flu vaccine choice and patients turning 65 in flu season 2018/19

14/9/2018

Following a query from a practice, we thought it worth highlighting an issue with vaccination for influenza and patients turning 65 during the flu season (ie who are currently 64 but will turn 65 before 31/3/2019).

The Flu Vaccine Programme Delivery Guidance for 2018-19 states the following:

"People who have their 65th birthday before 31st March 2019 will be eligible for influenza vaccine so may not be 65 when they are immunised. Which vaccine should they have?
It is appropriate to offer aTIV “off label” to those having their 65th birthday before 31st March 2019 and who are thus eligible to receive influenza vaccine under the currentdefinition of the ‘over 65’ group. Although aTIV is not licensed in those less than 65 yearsof age “off label" use is an option. The Public Health England (PHE) Patient GroupDirection (PGD) for inactivated influenza vaccine for 2018/19 will incorporate this off label indication."

When using the QMasters seasonal immunisations protocol, you will see the pop-up about the quadrivalent vaccine (QIV) when administering a vaccine to a 64-year-old (turning 65 this flu season). However, the subsequent picking list will let you administer whichever vaccine you consider appropriate. The PGD includes the recommendation to offer the aTIV for these patients.

The PGD for 2018/19 is linked below if you wish to use it.

PATIENT GROUP DIRECTION (PGD) - Administration of intramuscular (or subcutaneous) inactivated influenza vaccine to individuals in accordance with the national immunisation programme for active immunisation against influenza.

EMIS NUG September 2018

31/8/2018

QMasters will once again be exhibiting at the September NUG in Birmingham from the 6-7th September 2018. As well as coming to say 'hello' at our stand and seeing a live demonstration of our QToolset and/or QToolset Enterprise, do come along and see the following:

Dr. Merlin Dunlop, our Head of Development, participating in 'Challenge the Geeks' at 11.10-12.30 on Thursday 6th.

Dr. Miles Carter, our CEO, presenting: 'QToolset Enterprise: Integrating local referral forms, clinical pathways and best practice guidance in EMIS Web' at 14.40-15.20 on Thursday 6th.

Learning Disability QOF codes changing

18/6/2018

As of 1st April 2018 the business rules for QOF are being published in SNOMED-CT terms only, replacing the READ v2 codes we are used to.

We have noticed that a number of the clinical codes that were previously used as diagnostic codes for Learning Disability are being removed from the business rules. EMIS web has not in most cases been updated yet to reflect these new rules, which means that your system may still be using the previous (v38) searches instead of the new (v39) ones.

For details of the codes included in the v39 release, please see: https://rebrand.ly/QOFv39.

When your practice is updated, some patients who are coded with an 'old' Learning Disability code may disappear from the LD register unless you ensure their record contains a READ code which will translate to a valid SNOMED-CT under the new (v39) rules.

We have written a search that will identify those patients who are on the LD register under the v38 rules, but who will no longer be under the v39 rules. This will allow you to review these patients and decide if they should remain on the LD register. Please see the following document and downloadable search folder which will help identify these patients.

learning_disability_qof_changes_v39__qmasters_.xml
File Size:	12 kb
File Type:	xml

Download File

changes_to_learning_disability_qof_registers_with_v39_of_qof_business_rules.pdf
File Size:	358 kb
File Type:	pdf

Download File

GP Contract changes 2018/19

25/3/2018

NHS Employers has published the changes that are being made to the GP Contract for 2018/19.
A summary of the changes can be found here.

The main points to note include:

3.4% uplift in funding from 1st April (1% uplift in GP pay and 3% uplift to cover practice expenses).
£60m payment to practices to cover cost of indemnity inflation.
QOF is not changing at all in 2018/19.
Uplift to the item of service fee for certain vaccinations from £9.80 to £10.06.

QToolset Enterprise now available for CCGs

9/2/2018

QToolset Enterprise is our new customised solution for CCGs and large groups of practices. It offers everything in our standard QToolset with some really powerful new features:

Fully integrated local clinical pathways and local guidelines.
Fully integrated and managed EMIS Web referral forms.
Advanced reporting to assist CCGs and practices with contract performance monitoring and referral activity.

There is more information on our QToolset Enterprise page. Please contact us if you would like to see a demonstration or learn more about it.

EMIS advisory notice about calculators in templates

21/12/2017

Practices will have received an e-mail from EMIS Health about a recent issue with a calculator that was placed in a locally produced template. The calculator was not functioning correctly as the data being collected in the template was using a clinical code that is not recognised by the calculator.

Our QToolset uses calculators in a number of templates. We have thoroughly checked all of our templates and are pleased to confirm that the calculators all function entirely correctly and the clinical codes we are recording are fully compatible with each of the calculators we are using. There is no need to deactivate any of our templates.

Please contact us if you would like to discuss this further.

Seasonal vaccination tools for 2017 released

5/9/2017

We are pleased to announce the release of our 2017 seasonal influenza and pneumococcal vaccination tools.

Our seasonal immunisation tools work within EMIS Web to help maximise the number of patients who are offered a seasonal influenza and pneumococcal vaccination. Not only is high vaccination uptake a nationally audited hallmark of good clinical practice, but also it is one of the most profitable enhanced services, particularly when careful attention is paid to correct coding and administration.

These tools help with the opportunistic identification of patients who may require an offer of seasonal influenza or pneumococcal vaccination and automate the recording of batch numbers, expiry dates and sites of administration.

For more information and to download the tools, please visit: www.qmasters.co.uk/seasonal-immunisations.html

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