Q&A

If this group of patient have been coded as in remission in the past and have now experienced a new episode you will need to add the Read code for the appropriate mental episode (Example – Schizophrenia, Bipolar or other Psychoses) with either an episode type of ‘New’ or ‘First’, then code the care plan. You require the episode to be read coded with an episode type to supersede the ‘in remission’ Read code.

The prescription has to be issued in the preceding 6 months, if you do not issue the medication between 1st October to 31st March it will not count.

The Group will need to discuss with the CCG’s representative to agree which care pathways will be followed this year. For QP1 – QP3 the guidance suggests you may wish to look more closely at existing care pathways. The guidance outlined in QP1-3 applies to QP4 – QP9. If the care pathways from the previous year has not helped to maintain or improved areas for the referrals, emergency admissions and A&E avoidance, we would recommend you identify new care pathways.

If you are having a problem designing a Mental Health Care plan template you can request an example from Jill Warn.

The three care pathways cannot be the same for QP6-8 and QP9-11

QP11, more guidance related to this area can be found on page169 in the Quality and Outcomes Framework guidance for GMS contract 2011/12.

 

Total population 15 and over.

 

If a lifelong non-smoker they will only need it recorded the once unless under 25 years then its 12 monthly until the year of their 25 birthday. Once recorded as a non-smoker after their 25th birthday then it will not require again unless their status changes.

 

If an ex-smoker, a smoking status is recorded every 24 months unless you record it three consecutive years then it will not be required again unless their status changes.

 

Smokers require their smoking status every 24 months

 

Chronic Disease Registers

 

Patients who are on the disease registers If a lifelong non-smoker they will only need it recorded the once unless under 25 years then its 12 monthly until the year of their 25 birthday. Once recorded as a non-smoker after their birthday then it will not require again

 

If an ex-smoker, a smoking status is recorded every 12 months unless you record it three consecutive years then it is not required again unless their status changes.

 

Smokers require their smoking status every 12 months

 

There is no documentation in the guidance to suggest the advice has to be face to face but to fulfil the set criteria in the book you would need to discuss the options with the patient. This could be done over the telephone and documented as a telephone consultation with evidence of what was discussed.

 

Many practices are struggling with the new smoking indicators, Smoking 6 and Smoking 8.

 

Smoking 6:

 

The percentage of patients with any or any combination of the following conditions: CHD, PAD, stroke or TIA, hypertension, diabetes, COPD, CKD, asthma, schizophrenia, bipolar affective disorder or other psychoses who smoke whose notes contain a record of an offer of support and treatment within the preceding 15 months

 

Smoking 8:

 

The percentage of patients aged 15 years and over who are recorded as current smokers who have a record of an offer of support and treatment within the preceding 27 months.

 

To fulfil both indicators:

 

To be included in the dominator the patient would need to be listed as a ‘current smoker’ (A latest entry of one of the smoking QOF Codes).

 

To achieve the criteria for this indicator (numerator) for those patients in the denominator you have to have a record of being offered support and treatment in the preceding 15 months.

 

The smoking codes are as follows:

 

Version 2 – Advice and Support                                                                                      CTV 3

 

8CAL.      Smoking cessation advice                                                  Ua1Nz     Smoking cessation advice

8HTK.      Referral to stop-smoking clinic                                         XaFw9    Referral to stop-smoking clinic

8HkQ.     Referral to NHS stop smoking service                             XaQT5    Referral to NHS stop smoking service

8H7i.       Referral to smoking cessation advisor                             XaItC       Referral to smoking cessation advisor

8IEK.       Smoking cessation programme declined                        XaIye      Seen by smoking cessation advisor

9N2k.      Seen by smoking cessation advisor                                  XaW0h   Practice based smoking cessation programme start

13p50    Practice based smoking cessation programme start                    date

date                                                                                        XaX5W   Consent given for follow-up by smoking cessation

8IAj.        Smoking cessation advice declined                                                  team

8IEM.      Smoking cessation drug therapy declined                     XaX5X     Declined consent for follow-up by smoking

9Ndf.      Consent given for follow-up by smoking cessation                      cessation team

team                                                                                       XaRFh     Smoking cessation advice declined

9Ndg.      Declined consent for follow-up by smoking                   XaREz      Smoking cessation programme declined

cessation team

 

 

 

Version 2 – Pharmacotherapy  “ advice and support”continued

745H%.  Smoking cessation therapy                                                XaMwY%  Smoking cessation therapy

8B3f.       Nicotine replacement therapy provided free XaIQn     Nicotine replacement therapy provided free

8B2B.      Nicotine replacement therapy                                          XaEKU     Nicotine replacement therapy

8B3Y.      Over the counter nicotine replacement therapy          XaFst       Over the counter nicotine replacement therapy

8IEM.      Smoking cessation drug therapy declined                      XaMlI%   Smoking cessation drug therapy

du3..%    NICOTINE                                                                               XaXpT     Issue of nicotine replacement therapy voucher

du6..%    BUPROPION                                                                          XaZ01     Smoking cessation drug therapy declined

du7..%    NICOTINE 2                                                                           du3..%    NICOTINE

du8..%    VARENICLINE                                                                       du6..%    BUPROPION

du8..%   VARENICLINE

There are two ways in which a patient can be recorded as an ex-smoker.

In the preceding 15 months

Or

On three consecutive years (twelve month period) then there is no need to record again as the patient will be considered as a non-smoker unless their status changes and you enter another status code either during this time or after.

 

 

Thanks for your enquiry.  In the indicators mentioned in order to succeed in QOF 2012/13 (providing the patient meets the other indicator criteria) they would need a valid Read Code (in the appropriate timeframe) from the REFERSSSA_COD (Support and refer Stop Smoking Service/Advisor) cluster OR a valid Read Code from the PHARM_COD (Pharmacotherapy) cluster.  Therefore in your example it would be a logical ‘OR’ rather than an ‘AND’ to link your two statements i.e:

 

8CAL.     Smoking cessation advice

 

8IEM.    Smoking cessation drug therapy declined or  8B3Y.Over the counter nicotine replacement therapy or an issue of nicotine replacement therapy

No, both reviews can be completed at the same time. Approximately 15% of your COPD register will also have an Asthma diagnosis. I would suggest you combine both templates to ensure the reviews are completed where appropriate.

All Q&As
Clinical Indicators
  • Clear all
General information
  • Clear all

Join our mailing list

Keep up to date with all our latest new and upcoming events.