222 QI Answers to Your Quite Ingenious Questions: More of Your Questions Answered by the QI Elves

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222 QI Answers to Your Quite Ingenious Questions: More of Your Questions Answered by the QI Elves

222 QI Answers to Your Quite Ingenious Questions: More of Your Questions Answered by the QI Elves

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The documentary Where in the World Is Osama bin Laden? was found on Osama bin Laden’s computer. (Photo: Getty Images) How the team behind QI find their facts Closely monitor indicators that are time sensitive and require follow-ups after a set time period after a diagnosis. These are in relation to depression, cancer and diabetes. Two areas that require action within six months of diagnosis are asthma (AST006) and heart failure (HF005). For the former, there should be confirmatory spirometry and one other objective test in that timescale. For heart failure, this should involve an echocardiogram, or at a minimum, a referral for one. Crucially, these apply to all patients who were diagnosed after the 1st of April 2021. This means that, although these indicators were nominally suspended last year, your achievement during 2021-22 will still count towards this and subsequent year’s QOF. Paddington Bear wears a hat when swimming because Michael Bond’s father always did, in case he needed to raise it politely.

A box set of QI books containing 10,000 facts has been released by Faber – but can you astonish the researchers who found them, including the programme’s creator John Lloyd, with a revelation of your own? There are similar time sensitive indicators for follow up after a diagnosis of depression or cancer, and another for referral to a diabetes education programme. The diagnosis may have occurred during the 2021-22 ‘protected’ QOF year, which means the deadline for follow up of individual patients may be approaching. The actual timescales vary from 56 days for a depression review to three and 12 months for the cancer review. Diabetes education referral should be within nine months of the date of diagnosis. That is not to say that practices haven’t been active delivering routine care over the last couple of years. There is plenty of evidence to show that chronic disease monitoring and treatment has continued all through the pandemic. However, the return of the QOF this year means that being aware of and complying with all the rules again becomes important for maintaining practice income. So, what are the important areas to highlight? Be alert to those indicators that have deadlines Compiled by James Harkin, Anne Miller, John Lloyd and John Mitchinson Competition: How fabulous are your facts?Don’t be misled by the wording used for these indicators suggesting that only patients who are diagnosed in the current QOF year are included. This is not accurate – it is the date of the review or referral deadline that needs to be in the current QOF year, instead. On a slightly brighter note, any failure to achieve these indicators will only affect one year rather than every subsequent year, as happens with investigation indicators discussed above. Most indicators have been based on data from the end of the QOF year. It is normally possible to work through the year and then have a ‘tidy up’ right at the end. The second QI area, optimising access to primary care, has the same general structure. In this case most of the suggestions are around monitoring demand for appointments and how efficiently the appointments are used. The monitoring and auditing can be done by non-clinical staff although patient facing staff should be involved in plans to remodel services. The Elves are currently in research mode for next year’s Series Q so are quietly working their way through books about quails, Quebec and quadratic equations. Each series of QI is themed around a letter. The Christmas special from Series P will air at 10pm on Tuesday 18 December (with the XL edition to follow at 10:30pm on Saturday 29 December) and is pub-themed with questions covering pints, pies and pool tables.

Look at these areas urgently to see if you have patients diagnosed within the last six months without coded investigations – these would have been easy to miss at the time. GP Gavin Jamie summarises important changes to QOF for this year and the indicators practices need to pay close attention to urgently, if they are to avoid missing out on income. By far the simplest approach to creating your aims and action plan is to copy and paste the examples from the guidance with adjustments as needed based on the results of your baseline audit. You are welcome to create your own action plan and targets but this will involve additional work. There are no extra marks for originality.There is copious guidance available although the London General Practice Access Guideis suggested as a good source of information.



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