Q&A

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.

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)

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.

CTV3 – SystmOne

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

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.

You must ensure that you Read Code the health check as well as the action plan.  Remember also you need to add the number of patients with LD aged 14 and over onto CQRS once the quarterly extraction has happened. You need to locate the latest extraction, click on the payment link, add the patient number then re-submit. Once you have completed this action you are ready to declare. Although the LD claims are extracted it still requires one manual entry before declaring.

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.

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

CHS001

MAT001

QP domains

PE001: Ten minute appointments.

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.