Welcome to Inverness

Debbie CuthbertINPS Training Consultant

www.inps.co.uk

The Aims and Objectives are to discuss….

• Website and On-screen help• QOF

– QOF changes– Guidelines– Audits

• Vision+

www.inps.co.uk

Keeping you up-to-date:www.inps.co.uk

The Website Contains:•Blogs/release information •On-screen help •User Guides •Quick References •Video Tutorials •Release notes

On screen help

www.inps.co.uk

Features Request Forum

• Add suggestions to the Features Request Forum:

• Vote on other ideas. – These are reviewed daily– The more votes a request gets, the quicker it will be

developed.

www.inps.co.uk

Removal of whole Clinical Areas in 2014/15

• Whole clinical areas have been transferred to core funding:– Hypothyroidism– Epilepsy– Learning Disabilities– Obesity– Child Health– Maternity Services

www.inps.co.uk

Summary of Changes 2014/15• Reinstatement of QOF Timescales to 15 months• Register lines removed• Hypertension 12 months• Cholesterol removed• Diabetes

• Cholesterol, Albumin Creatinine, Retinal Screening, Erectile Dysfunction and Advice

– Depression• 10-56 days review for newly diagnosed patients

– Cancer• 6 month review

– CVD/PP • CVD risk assessment 15 months

– Exception changes

www.inps.co.uk

In addition

• The creation of a new Quality and Safety QOF domain which will retain anticipatory care plans but also include:

• Access: GP practices will undertake an annual assessment of current demand - assessing both met and unmet need. Practices will be encouraged to involve patients in the review process

• Integration: Each practice will nominate a liaison GP to link to a liaison person from the new health and social care integration partnerships

• Quality: A quality improvement visit will take place at practices once every three years. Practices will produce an annual quality programme report

• Further Reading….QOF Guidance Scotland 2014.pdf

www.inps.co.uk

To Sum up…

• 264 Points retired and moved to the core standard payment within the Global Sum– 80 Points Disease Registers– 33 Patient Experience– 151 QOF Clinical Areas

• So… 659 points remain– What is the impact…

www.inps.co.uk

2014/15 QOF

• Example: A practice in England with an average list size and prevalence earnings full points for Hypertension earned about £15 per patient last year. This year, approx. £6.

• As part of the retirement of disease registers, the 2014-2015 QOF guidance will include a general statement advising GP practices to continue to appropriately code diagnoses and provide clinically appropriate lifestyle advice

www.inps.co.uk

General Hints & Tips

• Discuss changes with everyone in the practice• Agree ethos and practice standards• Consider how you obtain information (could more be done on

the telephone or captured ad hoc?)• Share what is happening – include the success (everyone

always moans about QOF!)• Streamline recalls ? Month of birth

www.inps.co.uk

What INPS tools are available?

• The Business rules were released 28th May (one or tweaks still required), so we can now finalise:

– V28 Guidelines which will include the old and the new indicators (different colours to indicate each)

– Vision+ to incorporate V28 rules

– Clinical Audits v28 for Scotland (Monitoring)

www.inps.co.uk

Version 28 - Scotland

www.inps.co.uk

Management

www.inps.co.uk

Guidelines - Key Points

Key Points- Register Search- Guidance- Reference

www.inps.co.uk

• Vision+ is de-coupled in DLM 457. This is temporary as some customers experienced freezing issues.

• The functionality is still exactly the same but is accessed via these icons…

DLM 457

www.inps.co.uk

Vision+ QOF Templates

Key Points•QOF Templates•Easy to Use•Save & Close•History/QOF Tab•Show Indicators

www.inps.co.uk

All Templates

www.inps.co.uk

Start using Alert Indicators Now and tell Everyone!

Forward Date (understand the colours)

Ask about Flu/Smoking - move the prompts around!

Resize/Move/Print

Double click to enter data

Red Flag to Exception

www.inps.co.uk

Alert Indicators – Colour Scheme

www.inps.co.uk

Make sure everyone understands the Business Rules (Ownership)

• Indicator/Rule Logic • Clinical Audit Help

www.inps.co.uk

Now is the time to Consider …

• Validating your registers, which includes looking at your data and Verifying Prevalence rates:

– Clinical Audit - Data Quality Issues • H/O codes (h/o dementia)• Diagnostic Codes correctly used & dates entered• Involve everyone…(summarisers, scanners, clinicians,

managers)

– Analyse your data• Priority 1 (Patient Preview)• Pivot tables• Priority Update

www.inps.co.uk

Considerations..

– DXS Statistics - DXS

– www.gpcontract.co.uk for Prevalence trend data

– Contract Manager – use it as a monitoring tool…

www.inps.co.uk

DXS Statistics

www.inps.co.uk

Contract Manager – Clinical Indicators

Current Results - Update

www.inps.co.uk

Review your Recalls

– Identify the problem areas• Multiple and inefficient recalls

– Involvement• Who is currently involved, who

should be involved (eg community, practice staff, pharmacist)

– Multi-morbidities• Which co-morbidities (Clinical

Audit, Vision+)• High risk patients (COPD,

admissions)

– The Process• Start calling people early• Invitations and Recalls (what Read

codes are used and who enters them)

• Appointment availability• Data recording when the patient is

seen eg Templates– Evaluation & Benefits

• Audits to evaluate the effectiveness of the recall

• Less consultations, fewer visits, ?financial

www.inps.co.uk

Recall Management – Combining Registers

QOF

Questions So Far…

www.inps.co.uk

Access

• Practices will undertake an annual assessment of current demand, assessing met and unmet need.

• Following the annual assessment, practices will produce a ‘Patient Access Action Report’, which will be submitted to NHS Boards. Patients are encouraged to be involved.

• How…

www.inps.co.uk

Some Tools…

• Data Quality Audits

• Slot Utilisation Report in Appointments

• On-Line Analysis in Appointments

www.inps.co.uk

Some Tools

• National Vision User Group– www.nvug.org.uk

• Exports your appointment data

• Appointments wizard..• www.tailormadeit.co.uk

– Exports your Appointment data:» Time frame» Total number of appointments

www.inps.co.uk

Access

• You can analyse– Day, date and time– Staff ID, slot type (e.g. normal, triage, urgent, etc.)– Patient ID, comments– Appt. time, arrival time, called in time, wait time, out

time, expected duration, actual duration– Days to wait– Who made– Booking reason (method)– Waiting time– Duration of appointment

www.inps.co.uk

Use this information to..

– Compare demand against usage

– Weekly demand versus planned capacity

– Average number of patients by day made

– Normal, Triage, Urgent – days to wait

– Consultation Times – Expected and Actual Duration of Appointments

In Addition…

CalculatorsRegisters for Summarisers

National PrevalenceIndicator Points

High Value Patients

www.inps.co.uk

Vision+ Calculators

• The Vision+ Calculators cover 5 main areas:– Cardiovascular– Lifestyle– Mental Health– Other– Respiratory

Demonstration…..Demonstration…..

www.inps.co.uk

Vision+ Additional Information

• In addition there is:– Add to Register

• The benefits are that the patient immediately appears on the QOF Alerts

• Correct Read codes are used

www.inps.co.uk

High Value Patients Report

• High Value Patients– This shows the top 25 patients

and you can view the points by category (1000’th of a point)

– You can record contract codes, exception codes

– Once the work is carried out, the patient is removed from the report the next time it is ran

www.inps.co.uk

Questions & Where to go next…

• www.inps.co.uk• Ask the Trainer• THIN days• Webinars