The Core20Plus5 search folder is part of 012. Clinical searches (v4)

1. Core20 - the most deprived 20% of population, identified by the Index of Multiple Deprivation (IMD) or Townsend Score. This marker uses national deprivation statistics at postcode level to geolocate the most deprived areas.
   
2. PLUS - in addition to patients found in Core20, PLUS adds some extra groups such as patients of a BAME origin, but also significant groups defined at a regional or local which could include learning disabilities, drug & alcohol dependence, refugees or several others.
   
3. 5 - a final set of five nationally defined groups  to target (maternity; SMI; COPD; early cancer diagnosis*; hypertension casefinding*)
   

* The final two groups are not so easy to define using general practice data. See Denominators section lower down for more information

Searches

When viewing or sorting the report take care with the Townsend score, where negative or positive numbers will be shown. Do not confuse -3.2 with 3.2

Denominators folder

1. COPD - this group mirrors the COPD register. Patients with COPD are likely to be at greater risk of unplanned admissions due to a respiratory issue.
   
2. Currently pregnant + BAME or most deprived - BAME patients who are pregnant OR patients who are pregnant whose Townsend score is >2.5. These patients are more likely to experience complications during their pregnancy which could harm mother or baby. Placing an emphasis on continuity of care can help improve outcomes and reduce the chances of the baby dying or arriving prematurely.
   
3. SMI - this search identifies those patients on the MH register who have not been coded 'in remission'. Patients with a severe mental health condition are likely to have physical co-morbidities and have a statistically lower life expectancy.
4. Hypertension case finding - this search bears a similarity to the IIF CVD-01 indicator for 2022/23. Patients without a diagnosis of hypertension who have had a raised blood pressure in the last few years. It is worth following these patients up to rule out hypertension or form a diagnosis to manage. The limitation of this search is how many patients consistently have their blood pressure coded. Unlike other groups, there may be more patients in the community remaining undetected for a long time who do not attend the surgery.
   
5. Cancer diagnosis in the last year - the national guideline is to improve cancer diagnosis rates. This aspiration is difficult to achieve general practice alone, and data found in the clinical system on its own cannot identify a potential case of cancer. Instead, we have produced a search to list the number of patients with a new cancer diagnosis from the past 12 months with the idea that cases can be reviewed retrospectively for learning opportunities. Cancer coding can be tricky to get right in EMIS Web, especially when the diagnosis changes. To mitigate previous cancers being pulled into the search, we have excluded patients who have had a new coded diagnosis in the past 12 months, but also had another cancer code in the 12 months prior to that.
   The cancer diagnosis search could be run multiple times using a relative run date to review approximately how many diagnoses were made in the preceding 12 months (eg: run the search & report on 31/12/2022, but then re-run using relative run date on 31/12/2021, 31/12/2020, 31/12/2019 and so on.

Townsend Score