LD005 - Learning Disabilities register

LD005 - Learning Disabilities register

Warning
The codes referenced in this article are taken from the NHS Technology Reference Update Distribution (TRUD).  Not all of these may be present or selectable in all clinical systems.
Info
The information contained within this article is from version 50 of the Business Rules for Quality and Outcomes Framework (QOF).                                                                                  
Idea
This indicator has been retired from QOF (as LD004) but is still in the business rules and has a new for version 50 of this indicator onwards which allows patients to be removed from the Learning Disability register.  PCIT have retained this support article as this register is important for IIF                                                     

Indicator definition

Indicator ID

Description

LD005

The contractor establishes and maintains a register of patients with learning disabilities without a subsequent exclusion code


What are the criteria for this indicator?

In order to be included in LD005, patients must:
  1. have a diagnosis of a learning disability
  2. and do not have a code that excludes them from the LD register on or after their most recent LD diagnosis
Notes
The code to exclude a patient from the LD register was added in v50. The approach appears to have been replicated across some national indicators such as in IIF and the Learning Disability Health Check LES, but may not have been adopted by local enhanced service schemes or indeed in existing Practice authored searches.

What are the common pitfalls/what do I need to watch out for?

Alert
In November 2023 the NHS updated the reference set LD_COD, adding 300 diagnosis codes. Some 'new' codes unexpectedly added patients onto the register. Patients with codes of Dysequilibrium syndrome or Sjogren-Larsson Syndrome are included on the register even if they do not have a learning impairment. 
Both of these codes may have been added inadvertently; Dysequilibrium syndrome to describe a symptom of feeling off balance, and Sjogren-Larsson Syndrome picked in error when the autoimmune condition Sjogren's Syndrome was intended.
If either of these codes are identified, the more appropriate approach would be to address the coding in the record rather than adding a code to exclude a patient from the register.




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