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[seankennedy]

At this time last year the Greater Glasgow & Clyde GPASS Users Group held a very successful meeting going over all the various tools (in GPASS and external tools) to help practices manage and optimise their contract performance. Last year the situation was positive. There were good tools to help with QOF and all the enhanced services, national and local. The meeting was very helpful to share and demonstrate tools but overall people were happy that the situation was positive. This year we have not (yet) had an equivalent meeting. I have to say that if there was, I doubt very much that the mood would be equally positive. There are three elements to the contract (in pay terms): The Global Sum/MPIG is not really relevant to clinical software; QOF was well catered for last year and is still equally well catered for this year; Enhanced Services, at least national enhanced services (DES and LES) are a major part of our contract and, I have to say that they are often ignored completely. There are less than three months left in this financial year. Even if adequate support was given now, it is unlikely that practices will be able to maximise income from their DESs.

The Palliative Care DES will be well supported by Phase 1 of the new PALM. However, this will not be delivered in time for this year. I hope to get a Beta version next week but it would be very ambitious to hope that it will be rolled out in time to be helpful this year. In the meantime 2nd Opinion might offer a partial aid.

The ethnicity DES has been partially met by the software. We can at least record ethnicity but we lack a reporting tool to let us know how near or far we are from meeting the 30% target for this year. I’m told our IT facilitators hope to provide a search next week.

The Osteoporosis DES is perhaps the biggest gap in software provision this year. Hopefully practices are recording all fragility fractures (fractures in women aged 60 or older from a fall from standing height or less) with Read code N331N. If not, they need to search for all fractures in women aged over 60 after 1st November 2008 and check their notes to identify and record fragility fractures. All women over 75 with a fragility fracture are assumed to have osteoporosis (Read code N330 recommended but not compulsory) and, if already on bone sparing drugs need to have Read code 66a1 added. Otherwise they should be offered these drugs and record this with Read code 66a0. For women aged 60 to 74 with a fragility fracture they need to either be referred for a DEXA scan or have previous DEXA scans coded. Confirmed osteoporosis should be coded N330 and bone sparing medication coded in the same way as older women.