004B Routine QOF work | * Indicator Navigator | Mental Health

004B Routine QOF work | * Indicator Navigator | Mental Health

Mental Health

This folder supports practices in delivering and monitoring annual QOF care for patients with a diagnosis of severe mental illness. The relevant indicators cover care planning, alcohol and physical health monitoring, and include exception opportunities (PCAs) when care cannot be delivered.

Warning
The searches have been built to look at the contract year (1st April to 31st March), so it is recommended to run the search WITHOUT a relative run date.

🔍 [MH] Outstanding indicator and one invitation sent

Patients with one or more unmet mental health indicators (e.g. care plan, alcohol, BMI, BP, glucose/HbA1c, or lipids) who have received one invitation.

  • Action: Send a second invitation to allow exception coding for any indicators still outstanding.

🔍 [MH] Outstanding indicator and two invitations sent

Same as above, but patients have now received two invitations.

  • Action: These patients are now eligible for exception reporting for any indicators not completed.

🧾 DISENGAGED | Mental health patients who didn’t have a care plan last year

Patients who did not have a coded care plan in the previous QOF year. Indicates disengagement or missed care – ideal for recall or exception coding review.

🔍 NOT ACHIEVED | 1 mental health indicator outstanding

Patients who are missing 1 of the QOF mental health indicators this year. Quick to resolve – often a single check or coding issue.

🔍 NOT ACHIEVED | 2 mental health indicators outstanding

Patients missing 2 of the 6 mental health indicator components.

  • Tip: Resolving even one can improve QOF payment banding.

🔍 NOT ACHIEVED | 3+ mental health indicators outstanding

Patients missing 3 or more indicators. These are high-priority for follow-up or review for potential PCAs if care cannot be completed.

🧾 PCA CHECK | MH002 care plan not done previous PCA

Patients with no care plan coded this year and a past PCA recorded.

  • Action: Review whether the same reasoning still applies.

🧾 PCA CHECK | MH003 BP not done previous PCA

Patients with no blood pressure reading and previous PCA. Check for reapplication or assess if a BP can now be taken.

🧾 PCA CHECK | MH006 BMI not done previous PCA

Patients with BMI check outstanding and previous exception applied. Consider reapplying PCA if remains unsuitable.

🧾 PCA CHECK | MH007 alcohol not done previous PCA

Patients who did not have alcohol screening done, and had a previous exception applied. 
  1. Action: Review for potential reapplication of PCA or offer screening if appropriate.

🧾 PCA CHECK | MH011 lipids not done previous PCA

Patients without a lipid result this year and a PCA previously recorded.
  1. Action: Reassess the patient’s current eligibility or appropriateness for blood testing.

🧾 PCA CHECK | MH012 glucose/HbA1c not done previous PCA

Patients with no HbA1c or glucose check, and a prior PCA applied.

  • Action: Consider whether bloods are now possible or a new PCA is needed.