gp2 drs update a proctor
TRANSCRIPT
GP2DRS Update
Andrea Hewins (was Procter), IT Specialist, NHS
Screening Programmes
Public Health England leads the NHS Screening Programmes
GP2DRS
Email: [email protected]
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A centrally endorsed and standardised solution
to simplify the sharing of patient data between
GP practices and local DES programmes
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Key benefits of GP2DRS• Reduced risk of sight loss caused by
• Delayed screening due to new referrals being missed
• Screening invitations not being received due to out of date demographics
• Timely and accurate identification of demographic changes (moves, deaths
etc.)
• Reduced data transcription errors
• A standard approach to the acquisition of demographics from GP Practices
• Reduced workload for GP practice staff as the information is gathered
automatically
• Some potential reduction for administrative workload from programmes in
the long term
Future Benefits of GP2DRS• GP2DRS will be automatically moved over to SNOMED coding
• MIQUEST support is being withdrawn and will not support the move to
SNOMED
• Possibility in the future of obtaining extra information
• Pregnancy?
• Special requirements?
• Etc.
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What does GP2DRS provide• Currently
• Monthly list of all patients at a GP practice 12 and over coded as having diabetes
on the date of the extract
• Each list every month which will include new registrations, changes to currently
registered patients
• Patients will be removed from the list if they
• Have withheld consent
• Died
• De registered from that GP (but should appear with a new GP if re registered)
• Been coded as diabetes resolved (GPs should not be using this code in most
cases)
• Future
• Missing patients list which will give the reason a patient is no longer on the
register.
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Current status of GP2DRSLocal DES programmes
• 16 Programmes extracting from all their GP practices
• 14 extracting from at least some of their practices
• 6 in planning stages or interested
• 3 will notify us when they are ready to look at GP2DRS
• 2 not yet interested
• 23 yet to engage
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Implementation of GP2DRS• In pilot sites GP2DRS has identified up to 3% more patients than using
manual methods
• Programmes need to plan the extra capacity to manage this increased
workload to ensure these patients are all screened quickly
• Extra capacity may be required in HES as this may generate more
referrals
• Extra admin time will be required to
• Reconcile the GP2DRS list with the programmes current list
• Follow up with GPs patients not showing on the GP2DRS list (could be
for example incorrect coding or could be they haven’t notified you they
are deceased or moved away)
• Don’t let this put you off as there are clear benefits to patients who may
have been missed prior to GP2DRS
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GP engagement• GP Engagement is key
• GP’s must sign up to the service to allow the patients to be extracted
(many already have)
• They then have the option to say no to each monthly extract both when
the data is requested and when it is collated for sending
• If they don’t say no the data is automatically sent
• Ensure GPs
• Continue to send you patients through current channels to allow parallel
running and checking of possibly miscoded patients
• Sign up to the service (full details will be given to programmes to pass onto
GPs to ensure they have done this)
• Don’t block the extracts
• Respond to your queries about potentially incorrectly coded patients and
correct these
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Stakeholders• QA lead – please ensure you consult with your QA lead prior to
implementation
• CCG – ensuring your CCG is engaged will help with the sign up of GPs
• Hospital Eye Services – To ensure they are ready to manage any increased
demand
• GPs – As per previous slide
• LMC clinical leads
Extraction process
List of GP practices from programmes
• Do you have an accurate list of all your GP practices
• Is it up to date?
• GP2DRS support can help validate the list against NHS digitals list by CCG
List filtered by CQRS
• Practices need to sign up to GP2DRS on the CQRS service to participate
• Many have already signed up but still some who haven’t
• GP2DRS support can provide you with a list of those who haven’t signed up
• Instructions on how they can sign up can also be provided
S1N – can we run the query?
• Every extract practices will be asked if they’re happy to run the query to extract the patients
• Will run if they don’t respond
• Will not run if they say no
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Extraction process continued
S2N – can we take the data?
• Once the query has been run practices will be asked if they agree to send the resulting data
• Data will be sent if they do not respond
• Data will not be sent if they say no
GPES processing
• Data returned from practices is gathered by GPES (NHS Digital)
• Data is pre processed and reports produced and sent to GP2DRS support
Data loaded into GP2DRS
• Resulting can be downloaded from GP2DRS as a programme wide CSV file, by individual practice or viewed on a per patient basis
• Each programme has the ability to view and download the data for their GP practices
• Reports sent to programme regarding practices who did not send any data that month to allow programmes to chase these practices
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Example Data
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Policies & proceduresExamples include:
• An approach for managing non-participating GP Practices
• A process for providing data quality feedback to GP Practices
• Failsafe process for patients who opt out of screening
• Failsafe process for patients who withhold or withdraw consent for the
transfer and use of their demographic data
• Processes for reporting and resolving GP2DRS associated issues, i.e.
interaction with the GP2DRS Helpdesk
These should be reviewed as your experience with GP2DRS grows
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Example figures from a pilot programme
IncidentsIncidents regarding SCL/validation continue to be reported – this is
encouraging for SQAS and demonstrates services are making improvements
for the benefits of patients
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Safety Screening
Incidents
Serious Incidents Patients affected
Q1 2015/16 1 1 37
Q2 2015/16 7 1 131
Q3 2015/16 9 1 6616
Q4 2015/16 7 1 1814
Q1 2016/17 5 6 1874
total 29 10 10472
17% of all reported
incidents
Expect a GP2DRS incident• ?High number of patients not referred from GP practices
• ?High number of patients requiring demographic update/amendments
• ?High number of deceased and off-register patients
To resolve:
• May need additional administration/failsafe capacity
• Many need additional screening/grading/ROG sessions
• Introduce a risk stratification process
• Alert the HES/Clinical Lead to the potential increase in referrals
• Speak to the GP2DRS support desk
• Develop an action plan/implementation strategy for GP2DRS
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GP Practices
Pros
Automated extract – once set up they
don’t have to do anything each month
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Cons
May have to investigate coding errors.
Need to ensure they code correctly
Local Programmes
Pros
Standardised extract approved using
nationally agreed criteria
It’s free to use
Will be updated to work with new
coding schemes (e.g. SNOMED)
Provides an electronic extract each
month
Reduced requirement of resources
once in steady state
Timely update of patient demographics
Can be used to QA a current electronic
extract
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Cons
Initial increase in admin/failsafe
workload
Possibly initial increase in screening
workload if new patients are identified
Patients
Pros
Timely invites
Automatic update of changes in
address etc.
Won’t be invited if not eligible
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Cons
IG concerns?
Future work• Test and assure the missing patients extract
• See if we can obtain a legal “direction” for the data which would remove the
need for the 2 stage extract process
• Evidence the benefits of GP2DRS
• Input from programmes using GP2DRS or moving to GP2DRS required!!
• Form a GP2DRS user group
• Test and assure the move to SNOMED
• Test and assure a system upgrade in NHS Digital
• Continue roll out to all who wish to use it
• Make improvements to the usability of the system
• Investigate additional information which may be included in the long term
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