Project Name: Northern Ireland General Practice Heart Failure QOF Register Review Collaborative Working

Project Summary:

The Collaborative working will improve the accuracy of read coding for existing Heart Failure patients and aim to find those with a missing diagnosis through reviewing patients who have Heart Failure associated risk factors. The benefits include data cleansing and validation of the Heart Failure QOF registers, increasing QOF outcome generation and ultimately, this benefit patients through better diagnosis, review and improved management.

As part of the Project, ICS are performing register reviews in 12 GP practices across Northern Ireland, with The Roe Family Practice being one of these. The practice will provide Interface Clinical Services (“ICS”) with access to all patient records within the GP Practice to facilitate the Heart Failure QOF register review. Using the report provided by ICS, the practice will review all appropriate patient records and create a Heart Failure management plan for each patient to improve their Heart Failure care. Services provided by ICS will be funded by Novartis.

Planned Milestones:

MilestoneMilestone Date
Generation of ICS report1 month post project initiation
Completion of Consultation day by practice Heart Failure MDT1 month after completion of register review by ICS

Overall Project Milestones:

MilestoneMilestone Date
Group 1 (Practices 1,2 & 3) complete database review3 months after Project initiation, 3 months after practices signs individual CWA
Group 1 (Practices 1,2 & 3) complete Consultation Day4 months after Project initiation, 4 months after practices signs individual CWA
Group 2 (Practices 4,5 & 6) complete database review6 months after Project initiation, 3 months after practices signs individual CWA
Group 2 (Practices 4,5 & 6) complete Consultation Day7 months after Project initiation, 4 months after practices signs individual CWA
Group 3 (7,8 & 9) complete database review9 months after Project initiation, 3 months after practices signs individual CWA
Group 3 (7,8 & 9) complete Consultation Day10 months after Project initiation, 4 months after practices signs individual CWA
Group 4 (10,11 & 12 ) complete database review12 months after Project initiation, 3 months after practices signs individual CWA
Group 4 (10,11 & 12 ) complete Consultation Day13 months after Project initiation, 4 months after practices signs individual CWA

Expected Benefits:

The benefits to the patient include:

  • Proactive assessment and earlier detection of Heart Failure
  • Greater opportunity for initiation and optimisation of evidence-based Heart Failure therapies
  • Improvement in quality of care
  • Improved experience of the Heart Failure service

The benefits to the relevant NHS GP practice include:

  • data cleansing and validation of QOF
  • increasing QOF outcome generation

The benefits to Novartis include:

  • Creation of  more opportunities for the appropriate use of cardiology licensed medicines in line with NICE and clinical guidelines, including Novartis’ medicine
  • Better understanding of customers’ and patients’ needs specific to the management of Heart Failure but indeed more widely
  • Greater insight into the practical challenges and workings of delivering a high quality and sustainable Heart Failure Service
  • Improved reputation

Start Date and Duration: 

The Roe Family Practice

Start date: September 2022
Duration: 2 months from commencement of services being provided by ICS

Overall Collaborative Working Project

Start date: April 2022
Duration: up to 13 months

UK2210054116

Project Name: Northern Ireland General Practice Heart Failure QOF Register Review Collaborative Working

Partner Organisations: Dr Thomasius and Partners of The Roe Family Practice

Completion Date: October 2022 

Outcome Summary:

For an individual practice the Collaborative working has improved the accuracy of read coding for existing Heart Failure patients and found those with a missing diagnosis through reviewing  patients who have Heart  Failure associated risk factors.

Key Project Outcomes Data:

The relevant NHSGP practice provided Interface Clinical Services (“ICS”) with access to all patient records within the GP Practice facilitating the Heart Failure QOF register review. Using the report provided by ICS, the GP  Practice has reviewed all appropriate patient records and created a Heart  Failure  management plan for each patient to improve their Heart Failure care. The heart failure management plan has followed local guidelines The services are detailed below in Outcomes:

Outcomes:

ServiceOutcomeFurther Actions
Interrogation of Heart Failure QOF registers at the relevant GP practice by 3rd  party provider, ICS, to update the registers and find Heart Failure patients who are currently (un)diagnosed and/or not on the existing Heart Failure QOF registers.  
Consultation day provided by ICS to staff members at the GP practice to review results  
Percentage increase inpatients on the Heart Failure register15%Increase from 60 to 69
Number of newly identified Heart Failure patients9 
Increase in number of patients receiving NICE recommended therapy from baseline4 
Number of patients referred into 2nd care service5 

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