Volume 20.4 
Oct 2004

'Points mean prizes' under New Contract

In the first report from the front line, June Dowe provides a snapshot of how things are shaping up in her practice a few months into the New Contract.

So far so good with the New Contract for us. We are reasonably on target - helped with the purchase of a nifty bit of software called 'Contract Plus'. This clever little addition makes sure reminders jump out at you each time you bring up a patient's details on the screen, enabling you to fill the gaps like BP readings and asthma reviews due.

We have to remember 'points mean prizes' and with the use of exception codes for non-compliant patients we are fairly confident that all areas are more or less covered.

Each GP in the practice is responsible for different areas specified in the new contract and they have devised an appropriate profile for each condition to include all the necessary Read codes needed to review patients so they can be audited in the future.

'Umbrella monitoring codes' are added to the summary screen to make sure all patients are included in their specific group, ie one patient may have angina and another may have had an MI, but both patients would come under the CHD monitoring umbrella code to be reviewed in the same clinic.

There is still quite a lot of work to be done filling in retrospective gaps as although the GPs have often done the work - ie taken BP and entered into the paper notes - they have failed to drag themselves into the 21st century and use a Read code to enter the details on to the computer! Their minds are now being concentrated more on this task though, with the prospect of less money in their pocket if this information is not recorded.

A lot of emphasis is being put on the patient.s smoking status and our GPs find themselves grilling the patient to see if they have dared to smoke a cigarette since the last time they stepped over the surgery threshold or if they have stopped, when they stopped, or if they still smoke, offering counselling. By the time all this information is gathered the patient has often forgotten why they came in the first place! When a patient has never smoked we tick the summary box so at least the same question is not being asked over and over again.

The nurses are working hard, running clinics for Diabetic, CoPD, CHD and Asthma patients, and again they run through the Isis with pre Read-coded prompts, hopefully enabling future audits to run smoothly.

I have put SOPS [Standard Operating Procedures] in place for the dispensary and have also written SOPS for the GPs for the three Rs - Repeats, Reviews and Reauthorisation. Reviews and reauthorisations are mainly done in the surgery with patient/GP contact but we have a back-up system in place for patients who slip through the net. Reminders for blood tests, BP checks and general reviews are all stamped on the patient's repeat prescription slip when reviews are overdue.

The proof will be in the pudding when the final audits show how good or bad we've been. Let's just hope there will be enough in the kitty for our annual Christmas party!