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.
I can’t get the system to accept the codes for a Comprehensive Care Plan on a few of our patients. We have 6 showing as negatives but 5 have got Care Plans clearly documented from the hospital. They are dated from 21.5.15 to as recently as 23.10.15. No matter what code I put in be it on our own template or even using the GMS one they still remain negatives. On the home page I’ve even actioned the QOF reminder and used the GMS template and having selected the appropriate code the reminder turns grey.
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.
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
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
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
There are two ways in which a patient can be recorded as an ex-smoker.
In the preceding 15 months
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.
Could you please confirm to fulfill the Smoking indicators 6 and 8 – “support and treatment”, two Read codes are required. For all patients who fulfills the criteria, whose latest entry is “Current Smoker” the example entry below would achieve the indicator moving the patient from the denominator into the numerate 8CAL. Smoking cessation advice And 8IEM. Smoking cessation drug therapy declined or 8B3Y.Over the counter nicotine replacement therapy or an issue of nicotine replacement therapy
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.