Why are patients now appearing on QOF registers after SNOMED transition?

A common theme after transitioning from Read v2 to SNOMED was for Practices to discover that patients had been added to their chronic disease registers. The numbers were not often large, but had the potential to make the patient aware they were now on a disease register.

The reason for these additions was the way in which Read codes had been mapped to SNOMED, and the resulting choice of SNOMED codes for the QOF code clusters.

Patients who had previously been coded with Recurrent wheezy bronchitis [H30] [195949008] were added to the COPD register

Patients who had previously been coded with Post-concussion syndrome [E2A2] [40425004] were added to the Dementia register

Recurrent wheezy bronchitis is the original Read code term, but the preferred term for SNOMED is Chronic asthmatic bronchitis. Both terms share the same SNOMED Concept ID.

NHS Digital subsequently made changes in QOF v41.0 to the DEM_COD codeset for dementia which removed post-concussion syndrome from the inclusion list, but recurrent wheezy bronchitis remains on COPD_COD. 

Those patients with Recurrent wheezy bronchitis need clinical review to determine if they have a COPD diagnosis by another qualifying code or by diagnostic measures. Where it has been determined that a patient does not have a COPD diagnosis, all original Recurrent wheezy bronchitis codes need to be removed from the record and replaced with an alternative code which does not cause the patient to be added to a disease register. There is no suggested list of codes, but consider 'Wheezing' or even 'Wheezy bronchitis'; the latter term is used for the asthma register, although only if the patient is also receiving asthma medication.

• Related Articles

• 020D Registers

  Overview This folder is part of 020 Practice Administration This folder contains a host of registers which all feature patients whose most recent coding suggests they should be part of that register. Patients who have been removed with specific codes ...

• Read to SNOMED register attention needed

  The folder IOM Read to SNOMED register attention needed has been built by Primary Care IT to facilitate the identification of patients who have been added or removed from registers as a result of the code migration from Read v2 to SNOMED CT. Why is ...

• 004B Routine QOF work

  004B Routine QOF work The 004B Routine QOF work search folder is located within population reporting under the 004 GP Contracts Pro folder. The 004 Routine QOF work folder is divided into 7 main folders (shown in the screenshot below), as well as a ...

• 004C QOF VI searches (Child & Shingles vaccination uptake)

  The current version of QOF VI is v4 Unlike all other QOF indicators there are no declined codes for childhood vaccination indicators (VI001, VI002, VI003). There are however exclusion criteria to remove patients recently registered with the surgery ...

• Correcting Vaccine Entries in patients records arriving via GP2GP (DEGRADE entries)

  When patient records are transferred to your practice via GP2GP from a practice that uses a different clinical system, the data will often arrive in EMIS as a "Degraded" data item. This means that a code cannot be appropriately matched to a ...