Dr Simon Clay continues his online series of articles offering tips on how to maximise your QOF points. In this article he looks at mental health reviews.
The mental health review indicator 7 looks at the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who do not attend the practice for their annual review and are followed up by the practice team within 14 days of non-attendance.
To score anything for MH7, at least one patient has to have the following two codes entered:
• 9N4t (this patient DNA’d an appt for a MH R/V)
• 6A60 (mental health review follow up) i.e. the mental health review follow-up has been done. Note: 8HB8 is no longer valid
• The 6A60 code must be added on the same day or within two weeks after the 9N4t code date.
Reporting and verification
The document ‘Revisions to the GMS contract 2009-10′ does not specify exactly what mental therapy follow up should entail, but does say:
‘This indicator requires proactive intervention from the practice to contact the patient and enquire about their health status.
‘This may be through telephone contact or visit where appropriate. If the person is in contact with secondary care, it will be appropriate to contact their key worker to discuss any concerns. Evidence will be required as to how this contact has been made.’
In practical terms, my suggestion is that once a practice realises someone has not attended their mental health review appointment, they should contact the patient, by phone or by a visit (as felt appropriate) and perhaps suggesting another date for a review. Enter the two codes above on the same day – this keeps it simple.
This, in my opinion, will satisfy the criteria for MH7 and score you some points, with the rules as they presently stand.
Whether you then score all the points available for MH7 will depend on how many patients whom you document as having failed to attend a review have been followed up; 90% need to be followed up to score all three points.
Please note that the guidance document for the rulesets says explicitly that the 9N4t code should be added on the scheduled day of the MH review. The rulesets do not and cannot check this of course – though a visiting PCT team might at least ask about it.
N.B. These suggestions are based on the version 11.0 rulesets – released November 2007. Version 12 (Aug 2008) is the same as are later versions up to V16.0 (Dec 2009).
Dr Simon Clay is a GP in Erdington, Birmingham
QOF coding tips: mental health reviews More on QOF coding
This is part of a series of QOF coding tips from Dr Simon Clay. Read the other articles here.