System B, part of the Ardens LTC Recall System, allows practices to separate patients with single reviews outstanding from those patients that require multiple conditions reviewed. This system will benefit those practices that wish to send out bespoke information for patients with only one particular review outstanding (i.e. Asthma Florey Questionnaire) and to then focus on more complex patients with several conditions. 

It is important you have first read the introduction support article to understand the differences between each system and to remove the systems you will not be using to save on any confusion.

The following process will be carried out each month and will identify patients with outstanding reviews in a particular birth month. 

Locating the Searches

We recommend running and actioning folders 2.04 Review coding and 5. Data Quality within the 2. Detailed Review Searches folder before running your monthly invitation searches, to ensure all coding is accurate and prevent inviting patients unnecessarily for a review.  Further information on these search folders can be found here.

To access the searches navigate to the Population Reporting module > Ardens Searches > 1.10 LTC Reviews - LTC Recalls > 1. [System B] - Invitations- (single/multi review) folder.

Sending 1st Invitations Due

Expand the 1. [System B] - Invitations- (single/multi review) and right click on the 1st Invitations (Recall Month) (System B) folder. Select the option for Run, this will run all searches in this folder.

 The Run box will display. Click on Yes to continue.

The Run Parameters box will display. 

Ensure the date parameters are set as follows and specify which month of birth you wish to invite in:

Please note - do not add a fix date as this will return 0 results. 

Click on OK to run the searches. 

Please note - the searches will not include Care Home, EOL, Housebound and Learning Disability patients, separate searches to manage these patients are available in the 2.Detailed Review Searches folder.

Once the searches have been run, expand the 1st Invitations (Recall month) (System B) and select the a) Send 1st Invitations folder.

This folder will be split by the following:

• Multiple Reviews Outstanding - this will identify patients with more than one condition review outstanding.
• Single Review Outstanding - this will identify patients with only one condition review outstanding. 

You may wish to action those patients with a single review outstanding first and then action those patients with more complex needs (multiple conditions).

Select the Single Review Outstanding folder.

This search folder will identify all patients who are born in the chosen month (or have a recall arranged code added to their record), that have one outstanding review and they have not been sent an invitation for this financial year. These patients therefore will need a 1st invitation sent.

The search folder is broken down by sub folders:

The Single Review - All folder will list all conditions.

The top search of this folder will display the total number of patients with one condition review outstanding, this is then further broken down by condition.

Depending on your practice processes, you may wish to export the report for Asthma only and send the patients the Asthma Florey Questionnaire, or for your Hypertension/CHD/Stoke patients to export the reports to send the patient a generic message inviting them in for a Blood Pressure check. 

The further sub folders are broken down by condition to include reports to breakdown ways of communication.

Invite the patients accordingly using the preferred contact method.

Once invitations have been sent, click on the b) Code 1st Invitations > Code 1st Invitations- Single Reviews folder. This is an important step to allow the Receptionist to identify which conditions the patient needs a review for when booking an appointment and for the system to work out when a 2nd invitation is due.

This folder will contain searches for each long term condition (excluding Dementia, LD, Care Home, EOL and housebound patients, additional searches are available for this). It will also specify which code needs to be applied for each condition (please note - these are currently written as Read Codes but can still be typed in the SNOMED browser).

To add the code to all patients included in the searches, you will need to batch add the appropriate code, i.e. for Asthma you would batch add the code 9OJ4 to the results of Recall 1 - Asthma (batch add 9OJ4).

Select the search and click on the Batch Add option on the EMIS ribbon, followed by Clinical Code.

This will display the Add Batch Data screen. Click on the magnify glass located to the right of the *Batch Add field to open the Add a Code screen and apply the appropriate code.

Please note - the Descriptive text field can be used to include a set of instructions for the patients relating to their appointment, this will then pre-populate the Ardens recall letters. For further information on this, please see the following support article.

Click on OK once complete to return to the Add Batch Data screen. 

Enter a description in the Description field and locate the appropriate search using the Search Population (Included) field. 

Click OK once complete.

Repeat the above process for each condition search, this process will then remove the patient from the Send 1st Invitation list.

CKD, Epilepsy and Rheumatoid Arthritis are excluded from the main recall system searches as they only require a register to be maintained.  However, practices may still wish to recall these patients for a general review.  The Conditions without QOF annual review (optional) folder identifies patients with one of these conditions PLUS at least one other QOF condition outstanding a review.  Running these searches and batch adding the appropriate code will ensure that these conditions are displayed when using the F12 ‘LTC recall letter sent display’ protocol.

Once you have completed the single review invites, click on the a) Send 1st Invitations > Multiple Reviews Outstanding folder.

This search folder will identify all patients who are born in the chosen month (or have a recall arranged code added to their record), that have more than one outstanding review and they have not been sent an invitation for this financial year. These patients therefore will need a 1st invitation sent.

The top search 1st Invitation (Recall month): All will display the total number of outstanding patients for the specified month. The associated report All patients for 1st invitation - contact details + details of registers can be exported as a CSV file and filters applied, should you wish to prioritise particular conditions. Further information on exporting reports can be found here.

This search is then broken down by contact method:

• 1.Send 1st Invitation: SMS - will display patients with a mobile phone number on their record and have not declined contact by SMS. Patients can be sent a text.
• 2. Send 1st Invitation: Email - will display patients that do not have a mobile phone number or have declined SMS, but do have an email address and consent for emailing. Patients can be sent an email.
• 3. Send 1st Invitation: Post - will display patients that have neither of the above contact methods or have declined. Patients to be sent a letter. Please ensure you look at the following support article if using the Ardens Recall Letters. before coding.

Each of the searches above, include an associated report to view details of the patient's conditions and will contain everything you might need for Accurx/MJog/iPlato/Docmail etc. Click on the View Results option to view details of the reports and export to CSV if required.

Invite the patients accordingly using the contact methods above.

Once the invitations have been sent, an invitation code needs to be applied for each one of the patient's conditions. Following the same steps as the single reviews outstanding coding, use the b) Code 1st Invitations - Multiple Reviews searches to batch add the codes using the codes specified in the search name.

Ensure you have completed this for each condition search, this will remove the patients from the 1st invitation list when you re-run the searches.

Sending 2nd Invitations Due

Expand the 1. [System B] Invitations - (combined reviews) folder, right click on the 2nd Invitation (choose timeframe of 1st invites) folder and select Run.

The Run box will display. Click on Yes to continue.

The Run Parameters box will display.

Select a timeframe of your choice and this will return patients sent a 1st invite in the specified time frame and still have outstanding reviews. Some examples may be:

• Patients sent a 1st Invitation last month:

• Patients sent a 1st invitation in a particular timeframe:

• Patients sent a 1st invitation since April to date:

Click OK once complete.

Once the searches have been run, click on the 2nd Invitations (choose timeframe of 1st invites) (System B) > c) Send 2nd Invitation folder.

This folder is also split by Multiple Reviews (more than one condition review outstanding) and Single Reviews (only one condition review outstanding). 

For each folder, invite the patients in accordingly using the preferred contact method.

Once the patients have been invited, an invitation code needs to be applied for each of the patient's conditions. Following the same steps as coding the 1st Invitations, use the d) Code 2nd Invitation searches to batch add the codes using the codes specified in the search name (please note - these will be different codes to the 1st invitation coding).

Ensure you have completed this for each condition search, this will remove the patients from the 2nd invitation list when you re-run the searches.

Vulnerable Patients

Dementia, housebound, EOL, care home and learning disability patients will not appear in the 1st and 2nd invitation folders. There is a separate search folder to help manage recalling these patients.

Next Steps - Please see the following support articles:

• Identify which Condition(s) a Patient has been Recalled for - instructions on how to set up the F12 protocol for the Reception team to identify which condition a patient has been recalled for when booking an appointment. 
• Use of the 'Recall arranged' code - if you wish to apply code to a patient record on a month that is not their birth month.  
• Detailed Review Searches - for information on the searches for recalling Care Home, EOL, LD patients and other useful searches to support the management of chronic disease patients.
• Multi-Morbidity Templates - for capturing consultation data for patients with multiple conditions. 

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