MH011 - lipid check for SMI

MH011 - lipid check for SMI

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).                                                                                 

Indicator definition

Indicator ID

Description

The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of a lipid profile in the preceding 12 months (in those patients currently prescribed antipsychotics, and/or have pre-existing cardiovascular conditions, and/or smoke, and/or are overweight (BMI of >=23 kg/m2 or >=25 kg/m2 if ethnicity is recorded as White) or preceding 24 months for all other patients.

What do the business rules mean?

What makes a patient eligible?

Patients are eligible for the MH011 denominator if:
  1. they are on the Mental Health register (ie: have a diagnosis of psychosis, schizophrenia bipolar affective disorder)
  2. the most recent code relating to the diagnosis does not indicate that the patient is in remission

How to achieve the indicator

To meet the criteria for MH011, eligible patients must have:
  1. A lipid profile recorded in the QOF year and meet any of the following criteria
    1. Prescribed an antipsychotic in the last 6 months of the contract year
    2. Have one or more pre-existing cardiovascular conditions:
      1. CHD
      2. Unresolved diabetes
      3. Stroke
      4. TIA
      5. PAD
      6. Unresolved CKD 3-5
      7. Familial hypercholesterolaemia
    3. Current smoker
    4. Overweight
      1. BMI over or equal to 25 and white ethnic background
      2. BMI over or equal to 23 and latest ethnicity not white ethnic background
      3. BMI over or equal to 30 regardless of ethnicity
  2. A lipid profile recorded in the 24 months before the end of the QOF year and not meet any of the following criteria
    1. Prescribed an antipsychotic in the last 6 months of the contract year
    2. Have one or more pre-existing cardiovascular conditions:
      1. CHD
      2. Unresolved diabetes
      3. Stroke
      4. TIA
      5. PAD
      6. Unresolved CKD 3-5
      7. Familial hypercholesterolaemia
    3. Current smoker
    4. Overweight
      1. BMI over or equal to 25 and white ethnic background
      2. BMI over or equal to 23 and latest ethnicity not white ethnic background
      3. BMI over or equal to 30 regardless of ethnicity

What will remove patients from eligibility?

  1. Patients for whom mental health quality indicator care was unsuitable in the contract year
  2. Patients who chose not to have a cholesterol test in the contract year
  3. Patients who chose not to receive mental health quality indicator care in the contract year
  4. Patients who have been invited twice (at least 7 days apart) for review
  5. Patients who were diagnosed with mental health in the last 3 months of the contract year
  6. Patients who were newly registered with the practice in the last 3 months of the contract year
Notes
If a patient achieves the indicator at any point during the year, any exclusions that have also been added are ignored.

SNOMED codes used in this indicator

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.

Codes for mental health quality indicator care unsuitable for patient (MHPCAPU_COD)

SNOMED code

SNOMED code description

716301000000102

Excepted from mental health quality indicators - patient unsuitable

Codes indicating a patient has chosen not to have a cholesterol test (CHOLDEC_COD)

SNOMED code

SNOMED code description

141851000119107

Lipid screening declined

203151000000104
Cholesterol test declined
301111000000107
Lipid disorder monitoring declined
9471000175101
Hyperlipidaemia screening test declined

Codes indicating the patient has chosen not to receive mental health quality indicator care (MHPCADEC_COD)

SNOMED code

SNOMED code description

717051000000101

Excepted from mental health quality indicators - informed dissent

Invite mental health care review codes (MHINVITE_COD)

SNOMED code

SNOMED code description

1109921000000106
Quality and Outcomes Framework quality indicator-related care invitation
1110951000000105
Quality and Outcomes Framework mental health quality indicator-related care invitation
143431000000108
Quality and Outcomes Framework mental health quality indicator-related care invitation using preferred method of communication
248551000000108
Quality and Outcomes Framework mental health quality indicator-related care invitation using preferred method of communication
414669002
Mental health monitoring invitation
414668005Mental health monitoring first letter
414670001
Mental health monitoring second letter
414671002
Mental health monitoring third letter
416883000
Mental health monitoring verbal invitation
1084191000000101Mental health monitoring short message service text invitation