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QOF 2006/7

QOF 2006/7. Glyn Elwyn. Points. Reduced to 1000 points Now 655 clinical points 9 new disease registers Changes to existing indicators. CHD/Hypertension/Epilepsy Hypothyroidism. Lose LVD indicators More points for lowering cholesterol and BP.

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QOF 2006/7

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  1. QOF 2006/7 Glyn Elwyn

  2. Points • Reduced to 1000 points • Now 655 clinical points • 9 new disease registers • Changes to existing indicators

  3. CHD/Hypertension/Epilepsy Hypothyroidism • Lose LVD indicators • More points for lowering cholesterol and BP. • Age for Epilepsy register changed from 16 to 18yrs. • No change

  4. Stroke • Diagnosis needs to be confirmed by CT/MRI and/or further referral. • Anti-coag and anti platelet drugs now include Dipyridamole.

  5. Diabetes • Register – Distinguish between Type 1, Type 2 and Type 2 insulin treated. • More points for lowering BP. • Can also report on eGFR (estimated glomerular filtration rate) as well as creatinine. • HbA1C lower than 7.5 instead of 7.4

  6. COPD/Cancer • ALL pts to have COPD confirmed by Spirometry. • Record of FEV1 and inhaler technique in last 15 months, not 27. • Cancer care reviews needed for pts diagnosed in last 18 months only.

  7. MH • Now includes patients with Psychosis, Schizophrenia and Bipolar Affective. • No requirement to check lithium level although patients who have it checked need to fall within therapeutic range. • MHR – need to include Health Promotions. • Patients to have a care plan. • Patients to be followed up within 14 days if they DNA a booked appt.

  8. Asthma • Removed need to do flu jab. • New diagnosis after 1.4.06 need to have record of variability or reversibility.

  9. New Registers • Heart Failure • Palliative Care • Dementia • Depression • Chronic Kidney Disease • Atrial Fibrillation • Obesity • Learning Difficulties • Smoking

  10. Heart Failure • New diagnosis after 1.4.06 to be confirmed by echo or be specialist assessment. • These pts to be treated with an ACE inhibitor or Angiotension Receptor Blocker.

  11. Palliative Care • Complete Register 18+yrs. • The practice has regular (at least 3 monthly) multidisciplinary care review meetings where all patients on register are discussed. • Need representatives from NCMC, DN’s and George Thomas/Macmillan Nurses. • Have to code the meetings in the pt records.

  12. Dementia • Register • Patients diagnosed with dementia whose care has been reviewed in the previous 15 months. • ?22 patients – need to perform tidy up searches.

  13. Depression • No register • Patients with Diabetes and CHD • Ask 2 Standard Questions (in last 15 months) • In the last month - Bothered by feeling down, depressed or hopeless? • In the last month - Bothered by little interest or pleasure in doing things? • Temporary Code - #6891 – Depression Screen

  14. Depression • Pts with a new diagnosis of depression after 1.4.06 who have had an assessment of severity at the onset of treatment using an assessment tool validated for use in Primary Care, • PHQ9 – Free • HADS - Fee • BDI-II – Fee • Temporary Code - #388Z – Depression Score

  15. CKD • Register • Record of BP • BP less than 140/85 • Treated with ACE –I or ARB. • 5 stages – only includes pts with stages 3, 4 and 5. • To code stages need to work out eGFR. • Temporary code - #K060 – Renal Impairment

  16. AF • Not part of CHD, register in it’s own right • Pts diagnosed after 1.4.06 with ECG or specialist diagnosis. • Treated with anti-coag or anti-platelet therapy.

  17. Obesity/Learning Disabilities • Register of all patients with BMI >30 • Should code as 22K only when height and weight have been taken and Vision has calculated BMI. • Register of all patients with learning disabilities. • Permanent Code - #918e – on learning disability register. • E3, Eu7, Eu81z – Mental retardation codes

  18. Smoking • Combines CHD, Stroke/TIA, Hypertension, Diabetes, COPD or Asthma – record of smoking status in last 15months. • For those who smoke, record of smoking cessation advice in previous 15months. • No longer counted as part of a disease area.

  19. Records Indicators • Ethnic origin is recorded in 100% of new patients registered after 1.4.06. • All patients 15+ require a record of smoking status in the previous 27 months (used to be ever recorded). • BP of patients 45yrs+ is recorded in preceding 5 yrs for at least 65% or 80%.

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