IIF 2021/22

IIF 2021/22

The current version of IIF 2021/22 is v2.2
In October 2021, phase 2 of the Impact & Investment Fund (IIF) component of the Network Contract DES was released, increasing the number of indicators which Practices have to report on. The published business rules also give an insight into what is coming in the 2022/23 and 2023/24 years.

For October 2021 to March 2022, the following indicators were proposed. Indicators with an asterisk have been deferred:

Percentage of patients on the Learning Disability register aged 14 years or over, who received an annual Learning Disability Health Check and have a completed Health Action Plan
Percentage of registered patients with a recording of ethnicity 
Percentage of patients aged 65 years or over who received a seasonal influenza vaccination between 1 September and 31 March
Percentage of at-risk patients aged 18 to 64 years who received a seasonal influenza vaccination between 1 September and 31 March
Percentage of patients aged two or three years on 31 August of the relevant financial year who received a seasonal influenza vaccination between 1 September and 31 March 
Percentage of patients aged 18 years or over, not on the QOF hypertension register as of 30 September 2021, and who have (i) a last recorded blood pressure reading in the two years prior to 1 October 2021 >= 140/90mmHg or (ii) a blood pressure reading >= 140/90mmHg on or after 1 October 2021, for whom there is evidence of clinically appropriate follow-up to confirm or exclude a diagnosis of hypertension by 31 March 2022 
Percentage of registered patients on the QOF hypertension register
Percentage of registered patients referred to social prescribing
Number of Patients recorded as living in a care home, as a percentage of care home beds eligible to receive the Network Contract DES Enhanced Health in Care Homes service
Percentage of care home residents aged 18 years or over, who had a Personalised Care and Support Plan (PCSP) agreed or reviewed
Percentage of permanent care home residents aged 18 years or over who received a Structured Medication Review 
Mean number of patient contacts as part of weekly care home round on or after 1 October per care home resident
Confirmation that all practices in the PCN have mapped all active appointment slot types to the new set of national appointment categories, and are complying with the August 2020 guidance on recording of appointments
Number of online consultations on or after 1 October per 1000 registered patients
By 31 March 2022, analyse and discuss the implications of data on Type 1 A&E attendance rates for minor conditions with the local ICS, making a plan to reduce unnecessary attendances and admissions. 
Work collaboratively with local community pharmacy colleagues to develop and commence delivery of a plan to increase referrals to the Community Pharmacist Consultation Service, with referral levels increasing by no later than 31 March 2022
By 31 March 2022, make use of GP Patient Survey results for practices in the PCN to identify patient groups experiencing inequalities in their experience of access to general practice, and develop and implement a plan to improve access for these patient groups
Metered Dose Inhaler (MDI) prescriptions as a percentage of all nonsalbutamol inhaler prescriptions issued on or after 1 October
Mean carbon emissions per salbutamol inhaler prescribed on or after 1 October (kg CO2e)

Learning Disabilities

Nothing has changed here - patients who will be 14 or older on 31st March 2022 (ie born before April 2008) need to have an annual health assessment. Patients who decline a review can be coded accordingly to remove them from the indicator.

Ethnicity - NEW

Simply code as many patient ethnicities as possible. This applies to patients of any age. Codes to document that the patient refused to give their ethnicity are valid as it shows the Practice still surveyed for that information.

Seasonal Influenza

Nothing has changed here - the rules are the same as before. As with the seasonal flu enhanced service, the dates of birth relate to patients aged 65 on 31st March 2022.

Cardiovascular disease NEW

Two new indicators. CVD-01 is a complex indicator looking at the management of patients who were not diagnosed with hypertension as of 30th September 2021, and who had a BP reading at least 140/90 between 1st October 2019 and 31st March 2022. Demonstrate that these patients have been managed with a follow up, either by diagnosis and medication, or their recorded blood pressure has reduced.

CVD-02 takes a look at patients who are on the hypertension register on 31st March 2022 - in other words to observe an increase in the register size after 1st October 2021.

Social Prescribing

Nothing has changed here - simply reporting on the number of patients referred to social prescribing within the NHS year April to March.

Care Homes NEW

Some Practices may have some work to do to prepare for this indicator - all patients in care homes covered by the DES need to be coded with an appropriate code such as 'Living in a nursing home'. Consider that this code can only be used on these care homes, and should patients move out of a care home they should have a code added to remove them from indicator.
There is provision for temporarily living in a care home and again this is important to ensure it is coded. All members of the team should be aware of the coding implications, especially those managing registrations and change of address.
Care home residents are going to need Personalised Care and Support Plans completing and ongoing reviews.

Improving Access

The improving access to primary care services cannot be monitored using searches. All Practices should have already mapped their appointment slots by July 2021. Remember that mapping to the national standard is now mandatory moving forward, and you can refer to our supporting document here to ensure the correct mapping categories are used.

Green inhaler prescribing NEW

Green prescribing will become more widely known in the coming years. Think of the first 6 months until March 2022 as establishing a baseline of MDI inhaler issues as a percentage of the overall number of non-salbutamol inhaler issues. The payment threshold is 53% by March 2022, but be aware that the threshold is reducing to 44% by March 2023 and further reducing to 35% by March 2024, so there will be a significant effort to switch patients to greener options.
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