ICB Update Apr23

Message from Jo-Ann Sheldon, Head of Primary Care TH

Hi Everyone,

Please find attached revised TH LES specifications for 23/24 for:

• ICCQ Clinical

• ICCQ Enablers

• CYP & Digital Enabler specifications (these are embedded in the enabler document but attached in case any issues with opening)

• Surgical Aftercare and Wound Care

All other LES specifications remain unchanged from 22/23. An E contract Variation to the NC LES will be sent to practices later this week. We will also look to cascade the LES specifications via the TH generic inbox but I wanted to send to all Network Leads with some additional notes.

ICCQ Clinical

Please note some clarification points in existing KPIs and a note re aligning the retinal screening KPI

CP5

Action Plan for children with Asthma only

Number of Action plans completed within the preceding 12m

Please note there is no code available for Asthma action plan completed so the code in the template is:

This is the only code that is available to demonstrate added value but the requirement is not for full care planning. The LES widens out the asthma review in QOF from an evidence based disease approach to personalised planning. It should form part of the same appointment as an extended consultation. For more detail see page 4 of this spec

55%

CP6

Action Plan for Adults with Asthma only

Number of Action plans completed within the preceding 12m (to inc. wider det health enquiry)

Please note there is no code available for Asthma action plan completed so the code in the template is:

This is the only code that is available to demonstrate added value but the requirement is not for full care planning. The LES widens out the asthma review in QOF from an evidence based disease approach to personalised planning. It should form part of the same appointment as an extended consultation. For Adults a ‘Wider determinants of health’ enquiry should also be made. For more detail see page 4 of this spec

70%

CP7

Make wider determinants of health enquiries (measured as code social isolation yes/no codes) to all Complex and LTC patients and also newly (12m) diagnosed cancer patients who are not in one of those two groups

Important note – A new wider determinants snomed code is awaited, social isolation code to be used in the interim with free text. The conversation is about wider determinants not solely social isolation

80%

Diab2

% of all T2 diabetes patients having retinal screening in the previous 12 months plus 6 weeks (406 days by EMIS search) (exclusions for newly diagnosed & new registrants also excludes patients covered by 'Complex Care')

(NB. The timeframe in this KPI will be updated to align with the time frame set in the retinal screening service contract to ensure primary care not dependant on other services to meet this KPI)

86%

Diab 3

Percentage of patients <80 years with latest blood pressure reading within last 12 months <140/90 mmHg – note updated BP, in line with NICE guidance

65%

Asthma Action Planning

The guidance for Asthma Action Planning that was produced last year has been embedded into the specification and I attach here again, for clarity on the ask which has caused some confusion due to the lack of a snomed code for action planning.

IC Complex Patients

Each PCN will be provided with the number of discretionary patients they can have in this cohort at the end April 2024. Practices will need to choose and code the majority of individual patients by 22nd June 2024.

ICCQ Enablers

Children and Young People Access

The two draft letters (to the Young Person and the Parent/Carer) have been initially approved however, the CYP Leads are just doing a further review with key stakeholders. The final versions will be shared in the next month.

Transformation Projects

The current expressions of interest against these funds are being reviewed. We expect to be able to provide further feedback during April. We also plan to have some discussion regarding the projects when we attend the Network Boards in April and early May. Projects will be approved subject to further criteria being met. Initial funding and projects to start during Q1.

EMIS Clinical Services

Sam has been in touch asking all PCNs to submit an invoice to him urgently this week for payment. Further details on implementation will be provided in April.

Surgical Aftercare and Wound Care

Note the addition of Wound Care into the Surgical Aftercare specification. PCNs will need to agree with member practices whether the incorporated wound care service will be provided within Practices or at PCN level.

PCN Spirometry

The questions raised by PCNs are currently being looked at by LTC commissioning and clinical leads and feedback will be shared in the next couple of weeks. We are now looking at a start date of 1st July for this service

Coding

Please note it is increasingly very important that where specified we code all activity for both clinical and enabler work so we are able to demonstrate outcomes against funding to support retaining investment. Wherever possible we have provided coding requirements against enabler asks next year.

LES Training & LES QI Coaching Funds

Please note these two aspects of enablers remained in a one year contract with GPCG to end June 2023, following the move to the NC LES last year. Both these LES areas will be reviewed during April and May and further details re plans for 1st July onwards will be shared.

Webinar

We are looking to hold a LES webinar late April/early May, particularly to provide some further learning around some of the enablers (CYP and digital) and to answer any questions people may have. Date to follow.

Please do get in touch with Sam or myself if you have any queries

Kind regards

Jo