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CLINICAL GOVERNANCE LEADS MEETING

CLINICAL GOVERNANCE LEADS MEETING. 11 +12 DECEMBER 2007 QOF. QOF Profiling Reviews. All Practices profiled during July on 2006/7 data Qmas, qof, prevalence, exceptions, apollo, admissions, referals, prescribing

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CLINICAL GOVERNANCE LEADS MEETING

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  1. CLINICAL GOVERNANCE LEADS MEETING 11 +12 DECEMBER 2007 QOF

  2. QOF Profiling Reviews • All Practices profiled during July on 2006/7 data • Qmas, qof, prevalence, exceptions, apollo, admissions, referals, prescribing • Practices asked to respond to questions raised by the profiling +/- arranged visit

  3. QOF Profiling Review Outcome2007/8 11 QOF Review Visits • 6 former Bedford • 5 former Heartlands 7 Informal Practice Visits • 3 former Bedford • 4 former Heartlands

  4. QOF Profiling: submission evidence To ensure a consistent approach: all practices were asked to submit 2 examples of a Mental Health, Cancer and Dementia annual review. (unless already validated from visits etc)

  5. Results What % of submitted reviews met the Brown Book Standards? • Mental Health Reviews - 53% • Cancer - 61% • Dementia - 45%

  6. Some issues raised • Prevalence • Exception codes • Coding issues +/- IT issues • Not providing enough data to evidence a claim

  7. Low Prevalence? Practice audits discovered following reasons for low prevalence:- • Demographics • Read Code not used or not recognised by QMAS • Patients with the disease but not on the register • CKD ! • Event type needs to be first ever or new event – particularly for Cancer, Depressions, CHD (for MIs), CKD and Stroke

  8. Exceptions EMIS • Templates designed in such a way that exceptions codes (particularly Maximum Tolerated) can be easily entered without clinician realising exception code has been added to the record Isoft • Template error excepting patients for stroke/AF

  9. Exceptions • Use of max tolerated codes, especially epilepsy and hypertension • Use of blanket computer searches to identify and except people Remember – each exception MUST be an individual judgement with regards to that patient Remember – to explain in the clinical record why you have applied that exception to that patient

  10. Exceptions • Use of patient unsuitable instead of informed dissent • Coding at incorrect level – excepting at high level rather than individual indicators Remember – each exception MUST be an individual judgement with regards to that patient Remember – to explain in the clinical record why you have applied that exception to that patient

  11. QOF queries New Queries/Clarification

  12. QOF Queries • ‘New’ codes for Dementia annual review and MH dna – you may need to amend codes you have already applied • Depression 1 – the two question must be asked face to face (not validated when asked by letter). Remove any codes added in response to letter • Depression 2 - check your prevalence - should be 7-10% ish, • Episode type for Cancer, Depression, CHD (MIs) CKD and Stroke

  13. Medicines 11 & 12 • Brown Book 06/07 different guidance to Blue Book 04/05 • Brown Book states …

  14. Medication Reviews Med 11 & 12 • All patients should have the chance to raise questions and highlight problems about their medicines • Medication review improve or optimises impact of treatment on pt • Review undertaken in systematic way by a competent person • Any changes resulting from review are agreed with patients • Review documented in patient notes • Impact of changes monitored

  15. Medication Reviews Med 11 & 12 • All patients should have the chance to raise questions and highlight problems about their medicines • Medication review improve or optimises impact of treatment on pt • Review undertaken in systematic way by a competent person • Any changes resulting from review are agreed with patients • Review documented in patient notes • Impact of changes monitored

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