extracts data from the clinical system to support payment and management of various enhanced services. The automation of these monthly reports saved Practices having to construct their own searches, which did not always accurately reflect the specification, to complete manual returns.
CQRS has now been running automatic reports for a number of years, but with automation comes the need for Practices to be 100% accurate when carrying out procedures and coding. The CQRS searches reproduced by Primary Care IT have been designed to report the exact figures that will be shown on CQRS but also some searches with broader criteria which will show patients who might have been missed. Where the CQRS searches aren't 100%, use Check Patient
feature on Population Excluded to work out why patients haven't been picked up.
Why might a patient be missed from a CQRS report?
There are a number of different reasons why the broader search criteria might pick up a patient who has been missed:
1) The patient received the vaccination when they were too young or too old. Each vaccination has a specified age range where patients may receive them. There are often minimum and maximum ages which cannot be ignored, even by a single day.
2) The vaccination was given outside of the specified window. Often a second or third vaccination can only be given after a minimum period of time (eg: 28 days after the first vaccination) and there is no allowance for anything given at 27 days.
3) The code used wasn't part of the Business Rules codelist. The codes for each search are prescriptive; while for many searches there isn't much choice, use of long-standing alternative codes may mean a vaccination is missed from the search. If you are using your own templates to record vaccinations the codes may not reflect the current criteria. The use of EMIS codes, even where the code term is identical, is not counted by CQRS, but will be found by the broader searches.
For (1) and (2) it won't be possible to rectify the data to achieve payment, but these examples can be used within the Practice to learn about the missed income and make changes to ensure it doesn't happen in the future.
What CQRS searches are available?
Primary Care IT has built searches for most of the monthly services. For more information on the search sets, click on the services below.
Alcohol-related risk reduction scheme *Next release
Childhood seasonal influenza
HPV completing dose (booster) vaccination *Next release
Pneumococcal (PPV) vaccination programme
Seasonal influenza*Next release
Shingles vaccination programme
Please note only the payment indicators have been produced.
When using the CQRS searches, remember:
- The searches are designed to look at the previous calendar month, which is fine when reviewing the results prior to extraction but users may need to re-run the folder using a relative run date if reviewing after the CQRS extraction. 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).
- Patients must have been registered as patients before the end of the reporting month. This means that patients who left or died can be included.
- Left or deceased patients may be flagged as hidden in the patient list. Users must have RBAC B8029 (Manage detailed health records) on their login/smartcard in order to view the name or use Check Patient.
- Newly registered patients whose data was transferred via GP2GP may be included in the results. Due to the complex nature of the business rules, incorporating the rule in relation to when a code was added presents a significant layer of difficulty.
- Some business rules may specify codes and medication; the PCIT searches only consider codes as the structure of the searches cannot realistically take into account a mix of codes and medication.
The business rules and code cluster lists for enhanced services can be found on the NHS Digital website