• Exclusion codes - go to this
• Rationale - go to this

Patients will be included for this indicator if they have:

• A valid code for schizophrenia, bipolar disorder or other psychoses.

(They will be rejected if they are solely on Lithium treatment)

Codes for Mental health review (In the last 15 months)

6A6.. Mental health review
8BM0. Mental health medication review

Code if they did not attend invited mental health review

• The code for DNA MUST BE recorded on the date of the scheduled mental health review.
  The business rules now allow for 2 possible DNA events, the latest one and the earliest within the last 15 months. If a follow-up is recorded for either of these then the points will be awarded.

9N4t. DNA - Did not attend mental health review

Follow up (Must be within 2 weeks of the DNA date)

• If the earliest DNA date for the patient is within 2 weeks of the end of the current QOF financial year, the patient is not counted as the practice has not had time to complete the "Follow-up activities".

8HB8. Mental therapy follow-up (v10)
6A60. Mental health review follow-up (v9)

Psychosis, schizophrenia and bipolar affective disease codes

E10..% Schizophrenic disorders
E110.% Manic disorder, single episode
E111.% Recurrent manic episodes
E1124 Single major depressive episode, severe, with psychosis
E1134 Recurrent major depressive episode, severe, with psychosis
E114% Bipolar affective disorder, currently manic
E115% Bipolar affective disorder, currently depressed
E116% Mixed bipolar affective disorder
E117% Unspecified bipolar affective disorder
E11y.% Other and unspecified manic-depressive psychoses (excluding E11y2 Atypical depressive disorder)
E11z. Other and unspecified affective psychoses

E11z0 Unspecified affective psychoses NOS
E11zz Other affective psychosis NOS

E12..% Paranoid states (v9)
E13..% Other nonorganic psychoses (excluding E135.. Agitated depression)
E2122 Schizotypal personality

Eu2..% [X]Schizophrenia, schizotypal and delusional disorders

 

Eu30. [X]Manic episode

Eu300 [X]Hypomania

Eu301 [X]Mania without psychotic symptoms

Eu302 [X]Mania with psychotic symptoms

Eu30y [X]Other manic episodes

Eu30z [X]Manic episode, unspecified

Eu31. [X]Bipolar affective disorder

Eu310 [X]Bipolar affective disorder, current episode hypomanic

Eu311 [X]Bipolar affective disorder, current episode manic without psychotic symptoms

Eu312 [X]Bipolar affective disorder, current episode manic with psychotic symptoms

Eu313 [X]Bipolar affective disorder, current episode mild or moderate depression

Eu314 [X]Bipolar affective disorder, current episode severe depression without psychotic symptoms

Eu315 [X]Bipolar affective disorder, current episode severe depression with psychotic symptoms

Eu316 [X]Bipolar affective disorder, current episode mixed

Eu317 [X]Bipolar affective disorder, currently in remission

Eu31y [X]Other bipolar affective disorders

Eu31z [X]Bipolar affective disorder, unspecified

Eu323 [X]Severe depressive episode with psychotic symptoms
Eu333 [X]Recurrent depressive disorder, current episode severe with psychotic symptoms (v9)

Mental Health exception reporting codes (Added in the last 15 months)

9h9.. Exception reporting: mental health quality indicators

9h91. Excepted from mental health quality indicators: Patient unsuitable

9h92. Excepted from mental health quality indicators: Informed dissent

MH 7.1 Rationale

Poor compliance with medication is well recognised, and it is estimated that around 50% of people with schizophrenia do not always take their medication regularly. This may lead to relapse, hospitalisation and poorer outcome (Csernansky and Schuchart. CNS Drugs 2002; 16 (7): 473-484). There is also evidence to suggest that non-attendance at appointments may be interpreted by some practices as “irrationality”, as part of having a serious mental illness, rather than recognising that not turning up for an appointment may be a sign of relapse (Lester et al. BMJ. 2005; 330: 1122-28).

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.

MH 7.2 Reporting and verification

Practices report the percentage of patients who did not attend their annual review who have been followed up within 14 days of their non-attendance.

Prepared By Jean Keenan