|Relevant Tools:A.12, A.18|
Having agreed upon and discussed the review process, it is now necessary to search the practice records to identify all patients with a diagnosis of epilepsy. This section provides information and tools to help you do so.
The GMS contract requires only those who have a diagnosis of epilepsy, and who are currently receiving treatment, to be identified. This excludes those who have had epilepsy in the past and may have been off treatment and seizure-free for many years. The contract also notes that exception reporting (see A.18) will be more common in epilepsy than in other chronic conditions.1
The targets should therefore be achievable, but it is important to attempt to review all patients with a diagnosis of epilepsy, as some will have chosen not to take AEDs and would otherwise not be reviewed if only those receiving treatment were identified.
Using a combination of computer records and manual notes:
- identify patients taking AEDs
- identify patients with a diagnosis of epilepsy
- exclude patients taking AEDs for conditions other than epilepsy
- collate a register of people with epilepsy in the practice
- run a report of patients over 18 with epilepsy on AEDs
- run a separate report for patients under 18 with epilepsy on AEDs.
This section aims to aid in the compilation of a register of patients with a diagnosis of epilepsy and to flag any special considerations, such as:
- women with epilepsy
- patients with learning disabilities
- adolescent patients
- older patients.
Although fulfilling the quality indicators for epilepsy in the GMS contract only requires including those patients over the age of 18, it is still important that patients under 18 are identified. Not only will you need to know when they are old enough to be included in the future as the handover to adult care is a critical period, but these patients still require structured management as much as other patient groups. It is therefore important to ensure they are being regularly reviewed by the paediatric serviceand ask if they want a regular review in primary care.
A protocol to facilitate the identification of patients with a diagnosis of epilepsy is included in this section. Having identified these patients, you are then ready to send invitations to patients to attend for a review of their epilepsy.
The practice computer is central to the review process. External links search the computer and tell the Department of Health exactly which Read codes have been entered in your patients’ notes. Your practice payments for epilepsy care depend on how many of the correct Read codes have been entered. Further information on using Read codes can be found in A.18.
1 British Medical Association, 2013. QOF guidance, 2013-2014. [online] (Accessed 01/05/2013).