UPDATE AUGUST 2023 - 

As you will all be aware we made changes to our LTC invite system recently to allow for the coding of each individual conditions relevant QOF invite code. This change occurred following the announcement that the generic QOF code (Y1f8f) had been pulled from the business rules. Subsequently, NHS England has rolled back on this decision and announced in the next TRUD update the code will be reinstated into the relevant QOF code lists, and thus count as a personalised care adjustment at the end of the year.

Following a review of our system considering this NHS England change, we will not be reverting the changes and will in fact keep it looking at individual invite codes. As the LTC system itself runs off the Non-QOF invite codes this will mean practices can choose to add the generic QOF invite code if they wish or stick with the individual QOF invite codes. The code lists will be updated to cover whatever route practices choose to take, and neither option will have a negative impact on the functionality of the invite reports.

The rationale behind this decision is two-fold, adding the individual codes creates a more accurate record (all be it does add a slight admin overhead to the invite process) and makes care adjustments clear on the indicators they have been applied. The second part is it brings our SystmOne and EMIS recall systems more into alignment and thus allows for easier cross-practice working within mixed-system PCNs.

----- 

This article is designed to explain the changes we have put in place for the new invitation code process based on the v48 QOF business rules along with some easy-to-use reports to retrospectively code patients that have already been invited since April 23.

NHS England has now confirmed that the generic QOF invite code, Y1f8f, which many practices have been using as part of the LTC review invitations has been removed from the QOF business rules this year -

The specific condition invite codes enable practices to accurately reflect which care a patient was invited for as well as remove the ability to except patients from care that the practice didn’t invite them for and was never intending to provide. We acknowledge that removing the generic QOF invite codes will naturally increase the burden of now having to code for each of the clinical conditions, but it also addresses an issue where if the generic code were applied twice, this would except patients out of all QOF indicators with a ‘not responding to invites’ exception (if they didn’t receive an intervention).

The expectation is that with condition-specific invite codes, practices will be coding a patient more accurately, to reflect which care domains have the ‘not responding to invites’ exception applied to them and also ensure that patients are having the correct intervention as per their invitation received.  

To meet the requirements for a QOF exclusion for non-responders this year, patients must be coded with two condition-specific invitation codes a minimum of 7 days apart.

Note - For the most up-to-date list of codes that can be found in each code cluster please use the primary care reference set portal.

QOF Code Invitation Reports

We have therefore created some additional reports under the LTC Review folder to help make it easier to add the new codes. These reports can be found in Clinical Reporting > Ardens Ltd > LTC Reviews > 04 QOF Invite code | 1st Invite

as detailed below:

The QOF Invite codes that should be used for each LTC conditions are as follows:

Please note: The above codes can also be found within the relevant report name for convenience.

New Invitation Process for 1st invitations

The process that we now recommend you should follow is as follows:

Run the relevant month 1st invitation reports as previously and add the Long Term Condition 1st Invitation code (XabEf) as normal.  

As the generic QOF Invitation code can no longer be used, go to LTC Reviews > 04 QOF Invite code | 1st Invite folder and on the applicable month run each of the individual condition reports and add the relevant QOF Specific invitation codes on the patients records that you have invited.

Please Note: Each of these codes must be entered on the same day as the communication was sent to the patient.

New Invitation Process for 2nd / 3rd invitations 

To add further invitation codes, go through the normal 2nd or 3rd Invitational reports to create a communication for the patients and add either the Long Term Condition 2nd Invitation code (XabEh) or Long Term Condition 3rd invitation code (XabEj).  

Once the invitation has been sent, go into 04 QOF invite code | 2nd and 3rd invite reports and add the applicable LTC specific invitation codes to the records of the patients you have sent an LTC invitation to. Again please make sure that these codes get added on the same day as the communication was sent to the patient.

We have designed this process so that little additional work is required for practice staff as possible but will inevitably introduce additional tasks to code appropriately. NHS England acknowledged that by removing the generic QOF invite codes it will increase the burden of now having to code for each clinical domain.

Data Quality Reports for historical coding from April 2023

As the above process has been released part way through the year, we have designed some reports to make it easier to go back and backdate the applicable individual QOF invite codes into the patients record.  These can be found under Clinical Reporting > Ardens Ltd > LTC Reviews > 04 QOF Invite Code | Data Quality.  

To complete this process, 2 steps are required to capture all patients that have had an invitation, have the appropriate QOF codes added.

1. Adding LTC Invite Codes as General QOF Invite code added but no LTC Invite code

First run the above report to see how many patients have had the generic QOF Invitation code (Y1f8f) added to their records, but not had any of the below Long Term Condition Codes, which we recommend adding when sending patient invites.

Long Term Condition care planning invitation first letter - (XabEf)

Long Term Condition care planning invitation second letter - (XabEh)

Long Term Condition care planning invitation third letter - (XabEj)

Adding the appropriate above codes to these patients will then add them to the rest of the reports the next day so they can be coded with the appropriate QOF invite codes.

Breaking down a report will allow you to add the LTC Invitation code to the patients record on the same day as the generic QOF Invitation code was added. To break down results please see below.

Please Note: If you have 0 patients in this list it will be because you have been coding all invites with both the generic QOF Invite code and the above Long Term Condition care planning invitation code.

2. Add QOF Invite Code Reports

Running each of the below reports will show you the number of patients that will need to be coded with the respective QOF Invite code.

Each of the condition reports are split between first, second and third invite codes and each of the reports will need the code in brackets in the report name backdated into the patients record on the date the invitation code was added.  This can be done by breaking down a report.

Breaking Down Reports

To breakdown a report to find the date a code was added, right-click on the report that you have just run and select breakdown results.  Once in this screen, open the Event Details folder and tick Event date as detailed below.  Clicking the Refresh button will then bring up a list of Event dates the code was added to the patients record in the middle of the screen.  From this list, right-click on each Event date and choose Actions > Add Read Code.  You can then backdate the applicable code in bulk.

Please Note: For data quality, on all the retrospective reports, it is important that you backdate the individual QOF codes with the same date that the invitation was sent to the patient.

Sending LTC Invitations within the patients record

On the Invitations tab on the LTC Review template, it is possible to send an invitation to a patient ad hoc if required, 

The send 1st LTC, send 2nd LTC and send 3rd LTC invitation button has now been updated with a protocol that will add the relevant LTC Condition invite code to the patients record and will be displayed in the patients new and tabbed journal as below with the relevant QOF invite codes and the LTC invitation code.

To learn more about sending LTC invitations within a patient record, please see our Sending LTC Invitations Support Article for more details.

If you have any questions please contact our Support Team at support-systmone@ardens.org.uk. 

Please see our Recorded Webinars for further recorded training resources and also our Upcoming Webinars Support Article for information on upcoming webinars.