SystmOne Administrator Support Pack

This pack has been developed in association with GPA and WORTH to assist administrators with data quality and reporting for the Severe Mental Illness Health Check Incentive Scheme.

People with Severe Mental Illnesses (SMI) include any person with diagnoses of schizophrenia, bipolar affective disorder, other psychoses, and any patient on lithium therapy.

People with SMI:

• can expect to die 15-20 years earlier than those with no SMI diagnosis.
• 65% will die from a preventable physical illness – most likely cardiovascular disease, respiratory diseases, diabetes, or hypertension.
• are 4 times more likely to develop long term physical health conditions, and 10 times more likely to be hospitalised because of those conditions.
• are 3 times more likely to attend A&E with an urgent physical health need.
• are 3 times more likely to smoke.
• are 3.5 times more likely to lose all teeth.
• have double the risk of obesity and diabetes, 3 times the risk of hypertension and metabolic syndrome, and 5 times the risk of dyslipidaemia.

Northamptonshire are currently delivering a 6-point Annual Health Check to approximately 15% of the cohort, which is within the lowest quartile in the Midlands. In line with the NHS Long Term Plan to improve outcomes for patients with SMI and increase levels of achievement for the QOF Annual Health Check, the ICB have introduced a local incentive scheme in Northamptonshire.

The Local Incentive Scheme includes the usual six-point QOF check, with an additional six checks and any follow up interventions as required. All twelve elements and relevant follow up interventions will need to be coded.

An additional payment will be payable to practices based on the achieved enhancement level as of 31^st March 2023.

Ardens SMI Template

Outstanding actions show as a patient status alert on the ‘Home’ tab. Clinicians should complete the tab titled ‘Review – Physical Health’ and click ‘Ok’. Before ending the review, the clinician should re-open the template to check whether any of the patient status alerts remain.

Ardens Manager

https://ardensmanager.com
Ardens Manager is a web-based tool that gives a quick-glance overview of your progress towards QOF, PCN DES and SMI HC targets. If practices have not already signed up and accepted the contract, we recommend that you do so. Once you have accepted the contracts sent to your practice via Ardens Manager, and if a Data Sharing Agreement is in place, the ICB will upload data from your clinical system once a month.

SMI Register

Reporting -> Clinical Reporting -> Conditions | Mental Health -> Registers -> SMI Register – All

Case Finders

Reporting -> Clinical Reporting -> Conditions | Mental Health -> Case Finders

1. Psychotic disorder as h/o schizophrenia
2. Psychotic or bipolar disorder as on depot antipsychotics (and no dementia)
3. Psychotic or bipolar disorder as on lithium or antipsychotics (and no dementia)

Remission

Reporting -> Clinical Reporting -> Contracts | 2022 23 | SMI HC -> Q4 2022 23

1. Q4 2022-23 | SMI: Case finders – SMI in remission – No antipsychotics + no encounters >5years.
   ***To remove a patient in remission from this list, you will need to add a NEW EPISODE of a QOF remission code.

Post-Review Data Quality

Reporting -> Clinical Reporting -> Contracts | 2022 23 | SMI HC -> Q4 2022 23
Reporting -> Clinical Reporting -> Contracts | 2022 23 | SMI HC -> Q4 2022 23 work to do

There are multiple reports in this section that you will find useful for data quality; however, one in particular will be used to measure performance.

1. 2022-23 Q4 | SMI: PHC – All 6 core + 3 extra items recorded in last 12m
2. 2022-23 Q4 | SMI: PHC – All 6 core, 3 extra, oral + sexual health recorded in last 12m

Report Output

Run Report -> Show Patients -> Select Output -> Pre-defined report output -> SMI TPP Data report output

This report output can be applied to a report, and will show data for all 12 indicators and interventions, along with signposting to non-achieving codes that require amending, such as ‘Diet Notes’, ‘Drug Misuse Behaviour’ and ‘Non-Smoker’.

Q. How long does an SMI HC take?
A. The recommended appointment length is 30 minutes.

Q. Do all elements of the review need to be coded on the same day?
A. No. The codes can be on separate days between 1^st April 2022 and 31^st March 2023.

Q. Does the patient need to attend cancer screening appointments to meet the Annual Health Check targets?
A. No, provided the correct code for screening advice is added during the review.

Q. Which method should be used to invite patients for their review?
A. To maximise take up, it is recommended that you use several methods to invite patients for their review. A mix of letter, telephone call and SMS self-booking links from a named clinician will provide better results.

Q. Is there more training available for Ardens or Ardens Manager?
A. Ardens offer several training packages available and a comprehensive online support centre.