TABLE OF CONTENTS

Introduction

The Ardens Enhanced Services and V&I reports are not designed to act as payment reports. Instead, they are designed in a way that allows for ongoing data quality throughout the month, meaning once the data has been extracted by GPES there should be no need for any manual adjustments.  


The reports help identify potential data quality issues by highlighting activities not predicted to be identified by the GPES data extraction reports. The ‘not predicted’ reports have fewer business rules and requirements applied, which means they include more activities that could potentially be claimed for after further investigation. 


The Enhanced Services and V&I reports can be found in Reporting > Clinical Reporting > Arden's Ltd > Contracts I 2025 26 I ES and VI 


These reports have been built based on either the current or the previous month (and are automatically rolled forward on the 1st day of each month, for example, on the 1st of January the 'previous month' reports will look at activity recorded in December and the current month reports will look at activity recorded in January). 


It is also worth taking into consideration that TPP uses the same extraction reports month on month and simply rolls on the event dates. This means that there is never any historical GPES extraction data older than the current extraction month available within SystmOne. Each month as we approach the next extraction date the TPP reports will be updated to reflect the new month.


NOTE: Previously this folder was called 'CQRS' but we have changed the name to 'ES and VI' as this closely reflects the name of the services practices are claiming for, rather than the name of the website (CQRS) where these claims are made.


Current month I Manual claim

The HEPB003 extraction has now been retired, but some ICB's may still claim for this, so this folder will help with this. The two searches in this folder are based off of last years rules as now this is retired there are no up to date rules we can base this on. If your ICB does require this extraction, these reports can be run to see the activity for the current month. The 'Current month - Consider manual claim - 3rd dose Hep B + age >=12m + blood test | HEPB003' would have bee the extract so this is who can be claimed for manually. The 'Current month - Consider manual claim - 3rd dose Hep B + age >=12m + no blood test | HEPB003' acts as the 'not predicted to be in extract' search so practices can investigate these patients and see if they can manually claim for them or not.


Current month I Not predicted to be in extract

These reports will show patients who have had activity recorded in the current month but for whatever reason are not predicted to be identified by GPES for payment. The data identified in this set of reports will not have been extracted by GPES yet so there is time to review the records and take action to correct any data quality issues before the extraction takes place (This will also reduce the need for any manual adjustments claims after the extraction has happened).


Please note: These reports are very complex and may take a while to run. Rather than trying to run them all at once, it might be advisable to run these in small batches.


An example of a patient who may fall into these searches would be a new patient receiving their 2nd dose of DTaP/IPV/Hib/HepB - but as they are a new their patient record may not be up to date with any previous vaccinations they have had yet. The automatic extraction would then not count this as the '2nd' dose as the extraction logic would not see they had the 1st dose in the patients record. Therefore this patient would appear here in the 'Current month - Not predicted to be in extract | 6IN1002 - 2nd dose DTaP/IPV/Hib/HepB' search. In this case, they may have been extracted automatically as a '1st dose' as the extraction would just see the one dose recorded on their notes. A practice can then check this and make a manual adjustment as required. Of course, this is just one example of many possible scenarios, and an example of other issues is listed below.


Current month | Predicted to be in Extract

These reports will show you what we believe will be included in the next scheduled CQRS extraction. 


Previous month I Manual claim

The HEPB003 manual extraction reports as mentioned above but for the previous month.


Previous month | Not predicted to be in Extract

These reports are your lists of patients who have had activity recorded in the previous month but for whatever reason were not predicted to be identified by GPES for payment. Depending on the date, the work identified in this set of reports may have already been extracted by GPES. Ideally, these reports will return 0 patients as they will have been checked already when they were returned in the 'current month' reports but any remaining records should be reviewed then only if appropriate a manual adjustment claim should be made.


Previous month | Predicted to be in Extract

These reports will show you what has been predicted to be included in the last CQRS extraction. 


Possible reasons for non-inclusion in extraction

There are many reasons why an activity may not be identified for payment, some common reasons include -

  • Vaccination given outside of the contracts requirements
  • Wrong vaccine/dose recorded
  • Recorded with incorrect event details (elsewhere, PCN administration)
  • Wrong age
  • Entered too late for extraction but backdated
  • Registration status

Please Note: There are no reports for SFLU016, 017 or 018 as these are based on an immediately necessary registration type that we are unable to report on


Please Note: Any data for CQRS that requires a manual submission can be found in the respective folder in clinical reporting. For example, Weight management referral activity can be found in the Contracts I 2025 26 I NHSE folder.


Why is this patient appearing in a report?

This is a frequent question that is very often almost impossible for the Ardens Support team to answer without having access to the patient record which we clearly shouldn't have. This article about reporting Issues and frequently asked questions may help explain in greater detail how to investigate.


Further Reading