Q&A

Having checked the patients records we discovered they all had a BP reading entered in by the community services and although the Systolic reading was =< 150, all three patients had a Diastolic reading of between 91-93.

The system will look for the latest reading regardless of who has entered the data and it will look at both as both the Systolic and Diastolic readings have to fulfil the criteria.

To fulfil the criteria it states clearly the advice given by the practice has to be both verbal and written. There is now a specific Read code for the giving of leaflets, you will need to record both Verbal and written/ leaflet advice if using the individual Read codes that are now available for both Indicators.

The patient would need to be referred or have their diagnosis confirmed 3 months before diagnosis or one month after the date of the latest recorded Stroke/TIA. The Read Codes below are still available and would recommend you use the most appropriate the day of admission as A&E will refer for the test to be completed while the patient is an inpatient at the hospital.

CTV3

XaJkS  Stroke / transient ischaemic attack referral

XaJYc  Referral to stroke clinic

XaXOh Referral to transient ischaemic attack clinic

8HQ3.    Refer for NMR scanning

8HQ4.  Refer for CAT scanning

Version 2

8HBJ      Stroke / transient ischaemic attack referral

8HQ3.  Refer for NMR scanning

8HQ4.  Refer for CAT scanning

I agree it is really confusing. Open the GMS template for Stroke/TIA and click on the second tab. If you click on the QOF symbol on the template next to the CT/MRI link it will open up the QOF cluster and sitting in there is the referral code to the Stroke services

Version 2

8HTQ.     Referral to stroke clinic

8HBJ.     Stroke / transient ischaemic attack referral

8HQ4.     Refer for CAT scanning

8HQ3.     Refer for NMR scanning

CTV3

XaJkS      Stroke / transient ischaemic attack referral

XaJYc      Referral to stroke clinic

XaXOh    Referral to transient ischaemic attack clinic

Patient in the past would have been coded with an entry of Intermittent Claudication and this group of patients should automatically be picked up and form part of your register. You may also wish to audit patients with Diabetes who have problems with circulation.

CTV3 – SystmOne

Version 2 – Isoft, Vision, EMIS and Microtest.

There is a low exception Read Code for refusal of BP

Version 2 Read Codes

8I3Y.                    Blood pressure procedure refused

CTV 3 Read Codes

XaJkR                   Blood pressure procedure refused

We recommended a website to help with assessing if a child is obese. I have attached the link

https://www.cdc.gov/healthyweight/bmi/calculator.html

https://www.nice.org.uk/guidance/CG43

It is now possible to record a patient whose illness is in remission by entering one of the ‘in remission’ Read Codes. The patient will remain on the register but will be excluded from MH10-MH16 inclusive.

What constitutes ‘remission’ from serious mental illness can be found on page 21 of the Quality and Outcome Framework guidance book

The following codes are available:

If the therapeutic range is acceptable for the patient you should code the patient with the following code:

44W80  Lithium level therapeutic

This Read Code for both Version 2 and CTV 3 Read Codes

There are exception codes that can be added to the patient’s record but this will remove them from the indicator. The indicator is about prevention of secondary fragility fractures. Unfortunately the two patients on the register both refusing the bone sparing agents, would be removed and the indicator will again be zero for achievement. The patient needs to have had a prescription printed in the last six months of the QOF year (1st October onwards). If the patient has had a script since the 1^st October 2018 then you would have achieved the indicator.