For the recall system to be as universally useful as possible, we have made a number of customisable options available. 

Removing Atrial Fibrillation from recall

Some practices do not routinely recall patients for AF reviews. For practices to exclude these patients from the system, we have made the following process available within the toolkit.

Navigate to the 2. Detailed Review Searches folder located within the 1.1. Chronic Disease (QOF) Recall Syst folder and select the sub folder for 2.6. Exclude AF from recall folder.

Once the suite of searches contained in this folder is run, this will pick out all patients with Atrial Fibrillation.

In order to make these patients ‘opt out’ of recall for AF (they will still be recalled for any other condition they have), we have built a code into the system. When this is added to the patient’s record, they will not be recalled for AF.

To add this code to the required patients, select and run the search Atrial Fibrillation – to EXCLUDE from recall, batch run “Recall Excluder – AF”.

Batch add the protocol called Recall excluder – AF to the population. To do this, select Batch Add from the EMIS ribbon and select the option for Protocol:

In the *Batch Add field, use the magnify icon to search for the protocol 'Recall excluder - AF'.

Complete the rest of the boxes in the Add Batch Data box as shown below and click on OK.

This will add the code ‘Deleted from recall – not approp’ to all the included patients’ records. This will act as marker to exclude them from AF recall for this financial year.

Counting as reviewed CHD, Hypertension and STIA patients with BP this QOF year

Some practices may not code a specific annual review for the patients on these registers, but instead use the fact of a Blood Pressure being recorded in the financial year as a ‘marker’ of the patient having been reviewed.

In order to make this recall system work for these practices, we have created a folder which highlights the patients with CHD, Hypertension and STIA conditions who have had a BP recorded for this financial year.

Navigate to the 2. Detailed Review Searches folder located within the 1.1. Chronic Disease (QOF) Recall System folder. Here you will find a sub folder for 2.4. CHD/HYP/STIA with BP taken this QOF Year containing the following searches.

If required, the practice could then code these patients as having had a review, using the annual review codes provided in brackets. These patients will not be called again this financial year.

Care Home, EOL or Housebound by condition 

Separate searches are available for care home, EOL and housebound patients to allow practices to do monthly recalls for patients who have long term conditions.

Navigate to the 2. Detailed Review Searches folder located within the 1.1. Chronic Disease (QOF) Recall System folder. Here you will find a sub folder for 2.1. Care Home, EOL or Housebound, by condition.

The searches within this folder work similar to the main Chronic Disease Recall searches, and contain sub folders including the invitation lists and invitation coding, with the choice to invite monthly or by the whole year.

For Annual Review After Initial Review and Tests

For practices using the Ardens Multi-Morbidity templates, the following searches are available to identify patients who have had their initial review with the HCA (coded using the template) in the last 3 months (with time for any test results to come back).

The searches can be used for either inviting people back to see a Nurse/GP, or just for a clinician to review the notes and recent readings. It may be the case that they can consider the patient reviewed without getting them back in the building (either by a conversation, by telephone or just a notes review).

Interim Reviews

To support practices in identifying those CKD patients and diabetic patients who may require an interim review, searches are available in the  2. Detailed Review Searches folder, 2.3. Interim Review (CKD & DM) folder.

The CKD searches will help to call in CKD patients at intervals appropriate to their level of CKD:

The Diabetes searches will enable practices to identify patients who are due a 6-monthly HbA1c test

Patients with latest BP in QOF year > threshold

Allows practices to see patients who have a condition for which their BP needs to be in a certain range for QOF, in whom the latest BP this financial year is out with this range. The searches are available in the 2. Detailed Review Searches folder, 2.5. Patients with latest BP in QOF yr> threshold folder. 

Q4 Birthdays - Best Practice

The searches located in the 2. Detailed Review Searches > 2.7. Q4 Birthdays - Best Practice folder are available to help practices pick up patients who have a birthday in the last quarter of the financial year which perhaps do not manage to come in for their review until April, or the first quarter of the new QOF years. As they have then had a review in the ‘current QOF year’ they then would not be picked up for a recall when their birth month comes around. They could go 23 months without a review.

To prevent this, these reports pick up patients with a birth month on Q4 of the year who have had a review in Q1 of the current year. Practices could then review then to decide when / whether to recall them again.

Overview Searches

These searches allow practices to see the whole years’ work at a glance. This may help practices to plan when to run each month, or when more staff is needed!

If you require any further assistance on the process above, please contact Ardens support on: