You can locate the link on your home page on CQRS or through the NHS Digital link below


One of the contract changes for 2015/16 was that the Alcohol DES was retired from the Enhanced Services and made contractual. NHS England is still collecting the data on an annual basis but the payment is included in the Global sum.

No, for all the claims you are submitting manually you are only required to enter ‘0’ in the management section and enter the number completed in the second section. The management questions will be filled once automatic extraction has happened. This is why you should ensure you have used the correct Read codes for all the DES that will be extracted for CQRS.

Although it is a quarterly automatic extraction under the payment link, there is one manual entry to be made by the practice. You need to enter the number of patients on the LD register who are aged 14 and over.  This is necessary because the number will differ to your LD QOF register.

Yes, this should happen at the time of registration as it is still sits as part of your GMS contract under the global sum payment

Chads2 is a risk stratification scoring system used to assess a patient’s risk of a Stroke. The scoring system works as follows

C = congestive heart failure 1 point

H = hypertension 1 point

A = aged 75 years or over 1 point

D = diabetes mellitus 1 point

S2 = previous stroke 2 points

The treatment considered should be as follows:

Score 0 = low risk (Aspirin)

Score 1 = moderate risk (Aspirin or Warfarin)

Score 2 or more = high risk (Warfarin)

The Read Codes should be a value Code: Term

Version 2


Congestive heart failure, hypertension, age, diabetes, stroke 2 risk score



You will need to record a contraindication code for each therapy within the group (you would need to use 8I25. and 8I2K. and 8I24.) for the patients to be removed from the indicator. The codes overleaf are Expiring exception codes, you will need to record them every 15mths.

Version 2 – Isoft, Vision, EMIS and Microtest.




8I25. Warfarin contraindicated

8I2K.Clopidogrel contraindicated

8I24.Aspirin prophylaxis contra-indicated

8I3E. Warfarin declined

8I3R. Clopidogrel declined

8I38. Aspirin prophylaxis refused

8I65. Warfarin not indicated

8I6B. Clopidogrel not indicated

8I66. Aspirin not indicated

8I71.Warfarin not tolerated

8I6B. Clopidogrel not indicated

8I70. Aspirin not tolerated

8I2R. Anticoagulation contraindicated

8I3d. Anticoagulation declined

8I6N. Anticoagulation not indicated

CTV3 – SystmOne




XaFsz Warfarin contraindicated

XaJ6Y Clopidogrel contraindicated

XaDvH Aspirin prophylaxis contra-indicated

XaIIn Warfarin declined

XaJ6Z Clopidogrel declined

XaFsE Aspirin prophylaxis refused

XaIIh Warfarin not indicated

XaJ5l Clopidogrel not indicated

XaFsE Aspirin prophylaxis refused

XaJ5b Warfarin not tolerated

XaJ5c Clopidogrel not tolerated

XaJ5a Aspirin not tolerated

XaKAB Anticoagulation contraindicated

XaKAD Anticoagulation declined

XaKA7 Anticoagulation not indicated

XaKA0 Anticoagulation not tolerated

If the patient cannot tolerate an anti-coagulation drug or anti-platelet therapy you will need to exception report the patient from Warfarin, Aspirin, Clopidogrel and Dipyridamole to remove them from the indicator.

It does not say it has to be a face to face review. It can be done as a notes review. On SystmOne and Vision it is made easier as incorporated in the clinical system is a Chad2 tool which you would need to save to the records but if done by a non-clinician you would have to evidence you have followed-up the score if not appropriately prescribed.

The links are not yet available on CQRS but as soon as they are made available I will email practices. The following Indicators will require you to manually submit the answers:

PC002: Multi-disciplinary case review

CS001: Protocol

CS003: System for informing patient of results

CS004: Auditing inadequate



QP domains

PE001: Ten minute appointments.

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