CQRS: Learning Disability searches
The current version of CQRS: Learning Disability Health Check Scheme is v1
The Learning Disability Health Check scheme indicators are extracted automatically from your system approximately 10 days after the end of the monthly reporting period. Practices have a short opportunity to check their data prior to extraction and maximise their income potential. For reviewing data in historic months, the relative run date may be any date in the month following the achievement period (eg: for the achievement period of April, any date in May can be selected). Unlike other CQRS folders, PCIT has included the Management Indicators for Learning Disabilities.
Users familiar with IIF indicators will be aware that this scheme broadly mirrors the HI-01 indicator from 2022/23 contract year.
This article assumes the reader has access to CQRS, and can interpret the descriptions of payment indicators; only payment indicator codes are used below.
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Indicator
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Description
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Lower age limit
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Upper age limit (inclusive)
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LDHC021
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Monthly count of patients on the QOF Learning Disability register and aged 14 years or over, who received a Learning Disability Annual Health Check by the GP practice and have not previously received a health check within the financial year.
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14 years
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None
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Indicator
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Description
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Lower age limit
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Upper age limit (inclusive)
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LDHCMI034
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Percentage of patients on the QOF Learning Disability register aged 14 to 17 years inclusive who received a Learning Disability Annual Health Check between the start of the financial year and the end of the reporting period.
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14 years
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Day before 18th birthday
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LDHCMI035
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Percentage of patients on the QOF Learning Disability register aged 18 years or over who received a Learning Disability Annual Health Check between the start of the financial year and the end of the reporting period.
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18 years
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None
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LDHCMI036
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Percentage of patients on the QOF Learning Disability register aged 14 to 17 years inclusive who received a Learning Disability Annual Health Check and have a completed Health Action Plan between the start of the financial year and the end of the reporting period.
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14 years
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Day before 18th birthday
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LDHCMI037
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Percentage of patients on the QOF Learning Disability register aged 18 years or over who received a Learning Disability Annual Health Check and have a completed Health Action Plan between the start of the financial year and the end of the reporting period.
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18 years
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None
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The main searches closely mirror the business rules to properly reflect the CQRS count, but each search is also based on a denominator (dependency) search designed by PCIT to include patients who may not be picked up by the extraction. These are similarly named, but with square brackets (eg: [LDHC021] ). When reviewing the figures prior to CQRS extraction, Practices are looking for the searches to show 100%. When the search is not 100%, Practices can refer to the corresponding report in the Missed Activity folder. It is also possible to use the Check Patient feature to try to understand why a patient has been picked up in the denominator search but not for CQRS. There are several reasons why a patient may not be included in an indicator, and these all need to be considered.
Unlike other CQRS folders, there are no obvious codes that sit outside of the business rules.
- Patient was too young. A 14 year old whose first health check and action plan of the contract year was when they were aged 13 (but they had their 14th birthday soon after in the same month) will not count for the payment indicator for the remainder of the contract year.
- The code was added too early. The Action Plan code must be coded on the same day or later than the Health Check review code. If the Health Check and the Action Plan are not coded on the same day there is a finite amount of time for the Action Plan to be completed and coded before the end of the month to ensure payment.
Valid Codes
Learning Disability Health Check
| Term | SNOMED |
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Learning disabilities health assessment
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413126003
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Learning disabilities annual health assessment
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19975100000100
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Examination of learning disabled patient
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442127005
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Learning Disability Health Action Plan
| Term | SNOMED |
| Learning disabilities health action plan reviewed | 413163007 |
| Completion of learning disabilities health action plan | 712491005 |
Health Check declined (for management indicators)
| Term | SNOMED |
| Learning disabilities annual health assessment declined | 514021000000103 |
Missed Activity
Reports to help review potential data can be found in the Missed Activity folder, named with the indicator code followed by an X. If the searches have run, highlight the report and press View Results from the ribbon or right click for the quick menu.
The missed activity reports for CQRS have been designed in a standard fashion for ease of understanding.
CHECK - data in the CHECK column means that the codes used are correct, but the patient was either too old or young, or the Action Plan code is too early.
INVALID - data in the INVALID column means that activity has been found but with a different code that may indicate claimable activity. This column only focuses on the code and not on the age or the interval, meaning the report may need to be re-run or work out the time criteria yourself offline.
There may be a few scenarios where data appears in both CHECK and INVALID columns due to the way missed activity reports have been configured; prioritise CHECK before considering wither INVALID contains claimable activity.
Always check the 0% searches to ensure that single patients from the denominator are not missed!
The Full Hierarchy button on the ribbon can make checking the parent searches of 0% searches easier.
Review the CQRS article for points to consider when using these searches.
While the main searches have been built to closely mirror the business rules, there is a creative element to the denominator searches. Where the main search isn't 100%, don't discount that there are other factors which erroneously brought the patient into the denominator search. PCIT is always happy to hear about problems, but is unable to assist with every query why a specific patient is/isn't included.
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