Allergy Conference - 16th May 2024

EQUIP’s 2024 Allergy Conference is taking place on Thursday 16th May 2024.

This one day interactive conference is for GPs, Practice Nurses, Allied Health Professionals and anyone interested in allergy within general practice.

View details of the conference here

Q&A

Since the update to V45 , many practices have seen their Asthma review achievement  reverted back to zero.

It would appear that the Asthma Management plan Code used by many practices is not on the list of the QOF codes, the two acceptable SNOMED codes are:

XaRFi  Patient has a written asthma personal action plan (SNOMED 527171000000103)

XaYZB Asthma self-management plan review (SNOMED 810901000000102).

Also not all areas of the review may have been completed due to the present situation.

To achieve the review indicator, the Review code, Exacerbation code, ACT questionnaire, Self-management plan and the inhaler Technique should be coded on the same day, during the same consultation.

Many patients would not have had their Inhaler technique completed due to the reviews having been a Telephone consultation. The Asthma review indicator sits within the protected payment list (See the latest Guidance) and where it has not been possible to fulfil an indicator,  this should be written in your plan for managing the care delivered. Going forward for patients you have yet to review who are uncontrolled Asthmatics or are hard to reach, a Video consultation to review the patients inhaler technique may be an option if face to face is not possible.

185903001 Needs influenza immunisation
First dose codes
^999000881000001100 Enhanced services general practice extraction – Seasonal Flu nasal spray vaccines simple reference set
884861000000100 Administration of first intranasal seasonal influenza vaccination
1037311000000106 First intranasal seasonal influenza vaccination given by pharmacist
955661000000102 First intranasal seasonal influenza vaccination given by other healthcare provider
^999000891000001103 Enhanced services general practice extraction – Seasonal Flu injectable vaccines simple reference set
985151000000100 Administration of first inactivated seasonal influenza vaccination
1037351000000105 First inactivated seasonal influenza vaccination given by pharmacist
1066171000000108 Seasonal influenza vaccination given by midwife
1066181000000105 First inactivated seasonal influenza vaccination given by midwife
945831000000105 First intramuscular seasonal influenza vaccination given by other healthcare provider
955651000000100 Seasonal influenza vaccination given by other healthcare provider
955691000000108 Seasonal influenza vaccination given by pharmacist
955701000000108 Seasonal influenza vaccination given while hospital inpatient
Second dose codes
^999000881000001100 Enhanced services general practice extraction – Seasonal Flu nasal spray vaccines simple reference set
884881000000109 Administration of second intranasal seasonal influenza vaccination
^999000891000001103 Enhanced services general practice extraction – Seasonal Flu injectable vaccines simple reference set
985171000000109 Administration of second inactivated seasonal influenza vaccination
1037331000000103 Second intranasal seasonal influenza vaccination given by pharmacist
955681000000106 Second intranasal seasonal influenza vaccination given by other healthcare provider
1037371000000101 Second inactivated seasonal influenza vaccination given by pharmacist
1066171000000108 Seasonal influenza vaccination given by midwife
1066191000000107 Second inactivated seasonal influenza vaccination given by midwife
955651000000100 Seasonal influenza vaccination given by other healthcare provider
955671000000109 Second intramuscular seasonal influenza vaccination given by other healthcare provider
955691000000108 Seasonal influenza vaccination given by pharmacist
955701000000108 Seasonal influenza vaccination given while hospital inpatient
Contraindication codes
293112000 Influenza split virion vaccine adverse reaction
293113005 Influenza surface antigen vaccine adverse reaction
294647003 Influenza vaccine allergy
294648008 Influenza split virion vaccine allergy
294649000 Influenza surface antigen vaccine allergy
420113004 Influenza virus vaccine adverse reaction
822951000000107 Seasonal influenza vaccination contraindicated
822971000000103 Seasonal influenza vaccination not indicated
868491000000103 No consent for seasonal influenza vaccination
822931000000100 Seasonal influenza vaccination declined
822931000000100 Seasonal influenza vaccination declined
885971000000103 First intranasal seasonal influenza vaccination declined
885971000000103 First intranasal seasonal influenza vaccination declined
886011000000103 Second intranasal seasonal influenza vaccination declined
886011000000103 Second intranasal seasonal influenza vaccination declined

 

Invite Codes
1095821000000105 Influenza vaccination first telephone invitation (procedure)
1095831000000107 Influenza vaccination second telephone invitation (procedure)
200481000000107 Influenza vaccination invitation first letter sent (finding)
200491000000109 Influenza vaccination invitation second letter sent (finding)
315641001 Influenza vaccination invitation letter sent (finding)
711301000000108 Influenza vaccination invitation short message service text message sent (finding)
737041000 Invitation by telephone for influenza vaccination (procedure)
761311000000109 Influenza vaccination verbal invitation (procedure)
777791000000102 Influenza vaccination invitation first short message service text message sent (finding)
777831000000109 Influenza vaccination invitation second short message service text message sent (finding)
844941000000103 Influenza vaccination invitation email (procedure)
844961000000102 Influenza vaccination invitation first email (procedure)
844981000000106 Influenza vaccination invitation second email (procedure)
860151000000103 Influenza vaccination first verbal invitation (procedure)
860171000000107 Influenza vaccination second verbal invitation (procedure)

 

Vaccinations
22704311000001109 Fluarix Tetra vaccine suspension for injection 0.5ml pre-filled syringes (GlaxoSmithKline UK Ltd) (product)
27114211000001105 Fluenz Tetra vaccine nasal suspension 0.2ml unit dose (AstraZeneca UK Ltd) (product)
34680411000001107 Quadrivalent vaccine (split virion, inactivated) suspension for injection 0.5ml pre-filled syringes (sanofi pasteur MSD Ltd) (product)
34783811000001108 Fluad vaccine suspension for injection 0.5ml pre-filled syringes (Seqirus Vaccines) (product)
35726811000001104 Influenza Tetra MYL vaccine suspension for injection 0.5ml pre-filled syringes (Mylan) (product)
35727111000001109 Influvac sub-unit Tetra vaccine suspension for injection 0.5ml pre-filled syringes (Mylan) (product)
36509011000001106 Flucelvax Tetra vaccine suspension for injection 0.5ml pre-filled syringes (Seqirus Vaccines Ltd) (product)
37514711000001105 Fluad vaccine suspension for injection 0.5ml pre-filled syringes (Seqirus Vaccines Ltd) (product)
4365711000001104 Mastaflu suspension for injection 0.5ml pre-filled syringes (Masta Ltd) (product)

Hi Jill

With regard to the above support call, the reason that the Recurrent wheezy bronchitis codes are included in extract is because of the way that SNOMED CT codes map to Read codes:

•           Recurrent wheezy bronchitis is a synonym for the SNOMED code 195949008 Chronic asthmatic bronchitis. Our clinicians have confirmed this SNOMED code is a valid COPD code, therefore this code has to be retained in the code cluster COPD_COD for QOF version 41. This does mean that patients with H30.. Recurrent wheezy bronchitis will continue to be included on COPD registers.

We recommend checking whether your system supplier or your regional NHS England Team have provided any guidance regarding how to manage these patients.

If they have not provided any guidance and your clinicians have determined that these patients are not suitable to follow the QOF COPD care pathway then these patients would need to be exception reported for the purposes of QOF

Many thanks.

Regards.

Service Management Practitioner

 

I have sent a query to NHS Digital regarding the following two error on behalf of practices who have queried the following issues identified due to the Code matching to SNOMED for SystmOne practices:

I wonder if you are able to advise me please,  we have a patient with Essential thrombocythaemia the Read code is X20FX. This Read code was excluded on V37, it sits within the Coagulation Disorder chapter under the platelet disorder on the CTV3 browser but on V41 it sits with in the Primary malignant neoplasm (372087000) and has been included within the Cancer codes. It has  now carried this patient over on to the Cancer Register, although very small in number this has not been included in the past, can you clarify if this will be corrected please.

 We also have the issue with the CTV3 Read codes where patients with Post-concussion syndrome are now sitting on the Dementia register since the release of V41, these patients do not have Dementia and do not belong on the register. Is this going to be corrected too as it is not appropriate to compete a dementia review with these patients.

Hopefully we can have clarification if this will be updated before 31st March

Your help with this would be very much appreciated

 

 

I have sent the following query to NHS Digital regarding patients who are not sitting on the COPD register who does not belong there and am awaiting a reply. There is a small number of practices who have changed the historic  entry to a Bronchitis Read code which is not part of the COPD Cluster:

Could you please advise , on SystmOne there is a historic Read code H30..  Bronchitis:[ unspecified(& chect infect)] or[recur wheezy] – wheezy (other episode) which is no longer in use but there are many patients who have this in their records from historic entries and are now sitting on the COPD due to the code sitting within the  H3.. chapter due to the matching of SNOMED with CTV3 codes. The code did not sit within the COPD diagnosis cluster in the past

 As this data is historic, can it be excluded from the SNOMED COPD cluster or is this going to have to be a change of code by the practices, it does appear to be quite a number who have had this code entered in the past?

 

 

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

https://digital.nhs.uk/services/general-practice-gp-collections

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