The publication of the 23/24 Quality Outcome Framework (QOF) has a heightened focus on the role of cholesterol within secondary prevention with two new cholesterol indicators.
CDRC has developed a number of resources to help identify patients who would benefit from lipid optimisation and support practices to meet QOF cholesterol targets. These resources have been created in collaboration with the AHSN NENC and have been quality assured by NECS.
Below you will find details of the resources for lipid optimisation available in EMIS and SystmOne. If you have any questions or would like support from the CDRC team get in touch at contact-CDRC@ahsn-nenc.org.uk
Why use CDRC searches?
- Improve patient care
- Improve practice finances
- Approximately 20 min set up work
Tools used:
- CDRC Quality Searches
- CDRC Precision
QOF requirements
QOF has introduced a new set of indicators relating to the cholesterol in secondary prevention. There are 14 points relating to the proportion of patients who are taking statin for secondary prevention, along with a further 16 points for ensuring that the non-HLD cholesterol is lower than 2.5mmol/L in the previous 12 months.
CDRC Quality Tools
(1) SystmOne
The templates, protocols and searches are already available to practices on the CDRC website. Full instructions can be found at: https://cdrc.nhs.uk/resources/systmone-resource-centre/specialties/lipids-familial-hypercholesterolemiapcsk9i-inclisiran-overview/
(2) EMIS
If you haven’t already downloaded the searches and imported them into EMIS previously, do so from: https://cdrc.nhs.uk/resources/emis-resource-centre/emis-specialties/emis-cardiovascular-overview/lipids-familial-hypercholesterolaemia-fh-and-pcsk9i-guide-for-emis/
Searches Available
A list of all the searches can be found above, but the key searches are:
- ?Lipids 3.1 Management – consider lipid lowering for secondary prevention
- ?Lipids 3.3 Management – possible poor lipid lowering therapy concondance
- ?Lipids 4.3 Management – on low/mod lipid lowering – consider intensification
Coming Soon for EMIS – Intelligent Lipid Template and Protocol (similar tools are already in SystmOne)
An intelligent template that helps guide clinicians through lipid management and presents relevant information depending on whether for primary prevention, secondary prevention and whether at target or not is in the final testing phase. Please have a look by pressing F12 in a patient record to open the Protocol Launcher and search for CDRC Precision (why not add this to your shortcuts?). In the menu after the alert screen, click on “CDRC Beta Testing (do not use)” and choose “New CDRC Lipids”. This screenshot is for a dummy patient who is being treated for secondary prevention. This will be linked to a protocol that will add an alert to the QOF Box to advise on all CVD prevention indicators
Note: it is possible that resources in the beta testing phase contain bugs, but we would love feedback.
Get in touch
If you have any questions regarding access, or the use of the CDRC Precision tools, please get in touch: contact-CDRC@ahsn-nenc.org.uk
Real world example – impact of using CDRC searches for lipid optimisaiton
Preventing and managing CVD and its risk factors has the potential to improve population health, reduce health inequalities and ease pressures on overstretched health and care systems by reducing demand for services.
Using CDRC searches, practices in the North East and North Cumbria have been working with the CDRC team to identify patients at risk of a cardiovascular event, who need medication or need a change of medication.
In a five-month period at one GP surgery 326 patients were identified during a search. Of these:
| 219 patients were reviewed | 59 had their statin amended |
| 173 referrals were made | 35 had Ezetimibe recommended |
| 77 were potentially eligible for Inclisiran | 29 required no follow up or were at target |
| 18 started Inclisiran |
Tracy Marshall, Pharmacy Technician, said: “CVD is preventable, and by identifying people with disordered lipids and effective treatment, we can give them the best chance of avoiding a cardiovascular event. I work with practices to optimise patient medicines, with a focus on lipid management. The CDRC software has been a crucial element of identifying at risk patients, allowing me to prioritise and identify those who need new or updated medication. Support from the CDRC team has been invaluable – the team are responsive and have quickly refined searches and helped me tweak search results. This has ensured that I identify the right cohort of patients and there are no delays to patient treatment.”
CDRC: For NENC by NENC, for GPs by GPs. www.cdrc.nhs.uk