🧠 Simple Contract Mental Health (SMI) 2025/26

💷 How much is this worth to me?

This template supports achievement of multiple QOF indicators for patients on the Severe Mental Illness (SMI) register, including:

• MH002 – Annual face-to-face SMI review

• MH003 / MH006 / MH007 / MH011 / MH012 – Physical health checks (BP, BMI, alcohol, cholesterol, HbA1c)

It also includes fields to support local enhanced services (LES), which may require additional elements or combinations of checks to be completed.

Accurate completion ensures optimal patient care and protects income across both QOF and LES contracts.

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📊 High-level overview of the specification requirements

MH002: Mental Health Review

• A structured, face-to-face annual review covering health, social, and care coordination elements

MH003 / MH006 / MH007 / MH011 / MH012: Physical Health Checks

• Blood pressure

• Height and weight (for BMI calculation)

• Alcohol consumption

• Lipid profile (cholesterol)

• HbA1c

Lipid testing frequency varies depending on patient factors (e.g. medication, BMI, co-morbidities).

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📌 What do you need to know?

This template supports both QOF and LES components:

🧠 SMI Review (MH002)

Structured review may include:

• Health and social care needs

• Social support and service involvement

• Occupational status

• Early relapse signs and action plan

• Patient narrative on progress since last review

🡺 Tick to confirm that a Mental Health Care Plan was documented.

💉 Physical Health Checks

All items listed must be completed unless contraindicated:

• Blood pressure (systolic/diastolic)

• Height and weight → automatic BMI calculation

• Alcohol consumption (in units/week)

• Lipid profile

• HbA1c test

💊 Lipid Testing Interval Logic

Lipid profile must be repeated annually if:

• Antipsychotics prescribed in last 6 months

• Pre-existing CHD, diabetes, STIA, PAD, CKD, familial hypercholesterolaemia

• Smoker

• BMI > 23 or recorded as overweight/obese

If none apply: lipid test from previous QOF year is accepted.

⚙️ PCA and Exemptions

• Record clinical exceptions for:

  • BP, weight, or height not suitable or declined

  • Lipid testing declined

• Full PCA option to exclude patient from all SMI indicators

• Use invitation section to support exception coding if patient has not attended despite 2 invites 7+ days apart

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💡 Hints and Tips

• Lipid testing logic is dynamic — ensure all contributing factors are coded clearly to avoid false-positive failures.

• Include a short clinical narrative in the SMI review to summarise care and demonstrate engagement.

• Smoking status should be recorded separately to support lipid test logic and other QOF indicators.

• If weight or height is declined, tick both the decline and unsuitability codes where relevant to support robust exemption logic.