The Enhanced Health in Care Homes area forms part of the "Providing High Quality Care" domain of the Investment and Impact Fund. 


This area includes four indicators focusing on care home patients. Practices are required to:

  • Ensure care home resident status is correctly recorded in the clinical system.
  • All care home patients to have a personalised care and support plan agreed or reviewed.
  • Complete weekly care home ward rounds.
  • Aim for a reduction in emergency admissions.


EHCH-01 - Based on the care home beds aligned to the PCN (this is the CCGs responsibility), the aim of this indicator is for GP practices to accurately record in the clinical system the care home resident status for patients aged 18 years or over. There are no exclusions or exceptions for this indicator, all eligible patients must have an appropriate code existing in the patient record. The codes accepted are as follows:

  • Lives in a nursing home - 250560019 
  • Lives in a resident home - 1488625019
  • Lives in care home - 406371000000117
  • Living temporarily in care home - 2803151000000114 (only in the last 12 months)


Please note - the first three codes can be added at any time to be counted, the living in temporarily care home code is counted in the last 12 months. If a patient is no longer living in a care home a specific code must be used to be taken out of the denominator:

  • 360875003 – Moving to new residence (finding)
  • 36550903 – Housing ownership and tenure (finding)
  • 160943002 – Lives in own home (finding)
  • 1325731000000106 – Died in residential home
  • 71305009 – Died in learning disability unit
  • 88961000000101 – Patient died in residential institution
  • 876880009 – Died in care home
  • 698747008 – Patient died in care home


EHCH-04 - This indicator focuses on weekly ward rounds and a certain number of patient contacts per a care home.  The indicator will count appointments mapped to the appointment category of 'Patient contact as part of weekly care home round' and status of either 'Attended' 'Booked' or 'Did Not Attend' ((note - this appointment slot should only be used for patient-facing contacts). 

 

EHCH-06 - The aim of this indicator is for PCNs to improve on the number of emergency admissions. This particular indicator works on a downwards scale, therefore the lower the numbers will signify the improvement. 

 

Achievement


Indicator Points Threshold
EHCH-01 - Number of patients aged 18 years or over and recorded as living in a care home, as a percentage of care home beds aligned to the PCN and eligible to receive the Network Contract DES Enhanced Health in Care Homes service. 18LT - 30%
UT - 85%
EHCH-02 - Percentage of care home residents aged 18 years or over, who had a Personalised Care and Support Plan (PCSP) agreed or reviewed18LT - 80%
UT - 98%
EHCH-04 - Mean number of patient contacts as part of weekly care home round per care home resident aged 18 years or over13LT - Mean of 6 patient contacts per care home resident

UT - Mean of 8 patient contacts per care home resident
EHCH-06 - Standardised number of emergency admissions on or after 1 October per care home resident aged 18 years or over27Improvement:
LT - Reduction of 0
UT - Reduction of 0.02

LT - Absolute 0.15
UT - Absolute 0.1


Monitoring Network DES Activity for Care Homes

Navigate to the Ardens Searches > 5.32 Network Contract DES (NCD) (2022-23) > a. Investment and Impact Fund (IIF).

 

The Work done folder will show practice achievement.

 

The Work to do folder will identify outstanding work to be done:



For each TO DO search click on the "Population Included" tab to view the list of patients.


Please note - the EHCH-04 and EHCH-06 indicators are not available in these search folders due to the type of reporting data that is being extracted. Please see the below sections for further details on how you can track performance for these areas. 


Supporting Ardens Resources


Accurately recording patients care home resident status (supports EHCH-01)

The Ardens 'Care Home Review' template includes the option to record the patients care home residence.



To identify patients that are coded with a non-recognised care home code navigate to the Population Reporting module > Ardens Searches > 5.32 Network Contrct DES (NCD) (2022-23) > a. Investment and Impact Fund (IIF) > 2. Work to do > Care Homes > Care home data quality searches.


Once the below search has been run, select the "Population Included" tab to display the list of patients. Access each patient record and amend to the appropriate code:



You may also wish to review those patients that have the "Living temporarily in care home" code recorded in their record but it has been more than 12 months (remember this code only counts for the last 12 months):



Capturing the personalised care and support plan (supports EHCH-02)

The "Care Home Review" template includes a "Care Planning" page to capture details around the patient's personalised care and support plan:



If you wish to provide the patient or patient's carer with a copy of their care plan, launch either the Ardens "Future Care Plan" or "Universal Care Plan" document once the template has been saved. 



Monitoring weekly ward round activity (supports EHCH-4)

The Network Contract DES ward round data is extracted automatically via the GPAD system. This is an appointment based indicator and relies on the appropriate appointment category and status (see the top of this support article for further information). 


If practices wish to track performance on the ward rounds activity, the Ardens "Care Home Review" template includes a "Weekly care home ward round" code which can be recorded in the patients record (note this code is only to track performance and does not count towards achievement).



The searches to track this performance can be located in the Population Reporting module > Ardens Searches > 5.32 Network Contrct DES (NCD) (2022-23) > a. Investment and Impact Fund (IIF) > 3. Guide Only > Care Homes folder:




Monitoring emergency admission activity (supports EHCH-6)

The Network Contract DES ward round data is extracted automatically via a combination of the HES-SUS and APC/GPES systems. If practices wish to track performance on the emergency admission activity, the Ardens "Care Home Review'" template includes a "Emergency hospital admission" code which can be recorded in the patients record (note this code is only to track performance and does not count towards achievement).



The searches to track this performance can be located in the Population Reporting module > Ardens Searches > 5.32 Network Contrct DES (NCD) (2022-23) > a. Investment and Impact Fund (IIF) > 3.Guide Only > Care Homes folder:



If you require any further assistance on the process above, please contact Ardens support on: support-emis@ardens.org.uk