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Mental health (MH) QOF tips

Tips for improving QOF scores in this area and current indicators for 2013/14.

Brain scan of a schizophrenic patient during hallucination (Picture: SPL)
Brain scan of a schizophrenic patient during hallucination (Picture: SPL)

Tips for improving achievement

Paul Jenkins, chief executive of Rethink Mental Illness, says the key to boosting performance on the QOF for people with severe mental illness is 'through making reasonable adjustments at your practice, which will make it easier for those patients to engage with primary care'.

'Small changes can make a huge difference,' he says. For example, when inviting people to a physical health check, it’s helpful to give them a specific time and date, rather than leaving it open. Ensuring the booking system is as flexible as possible is also helpful, as some medicines make it virtually impossible for people to be coherent early in the morning'

'Good communication is also extremely important. For example, taking the time to clearly explain to patients, why physical health checks are so important for people with severe mental illness. If patients aren’t aware of the fact they are at a higher risk of conditions such as heart disease, they are much less likely to engage with such checks.’

In terms of the disease register, patients on lithium therapy are defined as patients with a prescription for lithium within the preceding six months.

QOF guidance also provides advice on remission from serious mental illness. It recommends that clincians should oly consider using the remission Read codes if the patient has been in remission for at least five years.

Where a patient is recorded as being in remission they remain on the MH001 register, in case their condition relapses at a later date, but they are excluded from inclusion in the indicators MH002-MH008.

For these reasons, the accuracy of coding should be reviewed on an annual basis by a clinician.

In the event of a patient experiencing a relapse, and being coded as such, they will once again be included in the associated indicators. Care plans dated prior to the relapse are not accepted for QOF purposes.

Current indicators

Mental health (MH) indicators Points Achievement thresholds

MH001: The contractor establishes and maintains a register of patients with schizophrenia, bipolar affective disorder and other psychoses and other patients on lithium therapy.

4

 

MH002: The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive care plan documented in the record (in the preceding 12 months - 15 months in Wales and N Ireland) agreed between individuals, their family and/or carers as appropriate.

6

England,  Wales, Scotland: 40-90%*

N Ireland: 30-55%

MH003: The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of blood pressure in the preceding 12 months (15 months in Wales and N Ireland).

4

50-90%

MH004: The percentage of patients aged 40 or over with schizophrenia, bipolar affective disorder and other psychoses who have a record of total cholesterol:HDL ratio in the preceding 12 months (15 months in Wales and N Ireland).

5

45-80%

MH005: The percentage of patients aged 40 or over with schizophrenia, bipolar affective disorder and other psychoses who have a record of blood glucose or HbA1c in the preceding 12 months (15 months in Wales and N Ireland).

5

45-80%

MH006: The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of BMI in the preceding 12 months (15 months in Wales and N Ireland).

4

50-90%

MH007: The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of alcohol consumption in the preceding 12 months (15 months in Wales and N Ireland).

4

50-90%

MH008: The percentage of women aged 25 or over and who have not attained the age of 65 (aged 20 or over and who have not attained the age of 60 in Scotland) with schizophrenia, bipolar affective disorder and other psychoses whose notes record that a cervical screening test has been performed in the preceding five years.

5

45-80%

MH009: The percentage of patients on lithium therapy with a record of serum creatinine and TSH in the preceding nine months.

1

50-90%

MH010: The percentage of patients on lithium therapy with a record of lithium levels in the therapeutic range in the preceding four months.

2

50-90%

*Indicates a threshold that has changed for 2013/14


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