Palliative care directed enhanced services: reporting template by pqhJNdjb

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									PALLIATIVE CARE ( Scotland) Directed Enhanced Services Template                         GUIDANCE

Summary
This template is prepared for the financial year ending      3/31/2012
                                                                            up 31/03/2011
New patients should be added to this register on or after the 01/04/2011 up toto 31/03/2012
Active patients from the Palliative Care Register 2008/09 should be transferred to this register following the instruction on the word document:
Transferring data from your existing Palliative Care template for 2010/11'
Patient details should be entered into the sheet called 'Data'- essential items are marked *
Optional data fields beyond the requirements of the DES have been included as these are likely to be useful to practices
The "Patient report" sheet allows practices to see the status of each individual patient
The 'Achievement report' sheet provides a summary of cases where requirements have been met for the Palliative and End of Life Care Directed Enhanced Service
The data from this sheet will be transferred directly onto the "Payment Claim" sheet which can be printed out and sent to your Board.


Data Sheet
Practice ID
Practice ID number should be entered

Adding patients
Add new patients by clicking on the relevant cell and adding the relevant information

Indicator achievement
1= achieved, 0=not achieved

Active/Inactive (Column N)
Change to "Active" where the patient has current palliative care needs
Change to "Inactive" where the patient does not have currently palliative care needs or has deceased

Patient Report Sheet
Go to sheet 'patient report'
Change the scroll bar to select the appropriate patient name
Click 'file', 'print' from the tool bar to print report

Achievement Report Sheet
All information is for patients added in the current financial year between 01/04/2011 and 31/03/2012
Number of patients added
Proportion where indicator 2 & 3 were achieved
Number of patients where indicator 4 is completed

Payment Claim Sheet
This sheet can be printed out and sent to your Board at year end to claim for payment
Select 'file', 'print' from the tool bar to print report




Contact
PALLIATIVE CARE ( Scotland) Directed Enhanced Services
                   Practice ID
                   NHS Board
                   Financial Year end    31/03/2012




                                                                                                                                                                               Date end of
                                                         Date patient      Date intial                     Date intial care                Date care         Date OOH          life                                Palliative Care
                    Patient                              added             care plan     Criterion 2       plan summary Criterion 3        plan last         Summary last      plan                                needs
No Patient Name     identifier       Diagnosis           to register*      completed*
                                                                           Enter in      achieved          sent to OOH*     achieved       updated           updated           completed*        Date of death     active/inactive
                                                         Enter in format   format                          Enter in format                 Enter in format   Enter in format   Enter in format   Enter in format
                    CHI number                           dd/mm/yyyy        dd/mm/yyyy                      dd/mm/yyyy                      dd/mm/yyyy        dd/mm/yyyy        dd/mm/yyyy        dd/mm/yyyy
 1                                                                                                     0                               0
 2                                                                                                     0                               0
 3                                                                                                     0                               0
 4                                                                                                     0                               0
 5                                                                                                     0                               0
 6                                                                                                     0                               0
 7                                                                                                     0                               0
 8                                                                                                     0                               0
 9                                                                                                     0                               0
10                                                                                                     0                               0
11                                                                                                     0                               0
12                                                                                                     0                               0
13                                                                                                     0                               0
14                                                                                                     0                               0
15                                                                                                     0                               0
16                                                                                                     0                               0
17                                                                                                     0                               0
18                                                                                                     0                               0
19                                                                                                     0                               0
20                                                                                                     0                               0
21                                                                                                     0                               0
22                                                                                                     0                               0
23                                                                                                     0                               0
24                                                                                                     0                               0
25                                                                                                     0                               0
26                                                                                                     0                               0
27                                                                                                     0                               0
28                                                                                                     0                               0
29                                                                                                     0                               0
30                                                                                                     0                               0
31                                                                                                     0                               0
32                                                                                                     0                               0
33                                                                                                     0                               0
34                                                                                                     0                               0
35                                                                                                     0                               0
36                                                                                                     0                               0
37                                                                                                     0                               0
38                                                                                                     0                               0
39                                                                                                     0                               0
40                                                                                                     0                               0
41                                                                                                     0                               0
42                                                                                                     0                               0
43                                                                                                     0                               0
44                                                                                                     0                               0
45                                                                                                     0                               0
46                                                                                                     0                               0
47                                                                                                     0                               0
48                                                                                                     0                               0
49                                                                                                     0                               0
50                                                                                                     0                               0
51                                                                                                     0                               0
52                                                                                                     0                               0
53                                                                                                     0                               0
54                                                                                                     0                               0
55                                                                                                     0                               0
56                                                                                                     0                               0
57                                                                                                     0                               0
58                                                                                                     0                               0
59                                                                                                     0                               0
60                                                                                                     0                               0
61                                                                                                     0                               0
62                                                                                                     0                               0
63                                                                                                     0                               0
64                                                                                                     0                               0
65                                                                                                     0                               0
66                                                                                                     0                               0
67                                                                                                     0                               0
68                                                                                                     0                               0
69                                                                                                     0                               0
70                                                                                                     0                               0
71                                                                                                     0                               0
72                                                                                                     0                               0
73                                                                                                     0                               0
74                                                                                                     0                               0
75                                                                                                     0                               0
76                                                                                                     0                               0
77                                                                                                     0                               0
78                                                                                                     0                               0
79                                                                                                     0                               0
80                                                                                                     0                               0
81                                                                                                     0                               0
82                                                                                                     0                               0
83                                                                                                     0                               0
84                                                                                                     0                               0
85                                                                                                     0                               0
86                                                                                                     0                               0
87                                                                                                     0                               0
88                                                                                                     0                               0
89                                                                                                     0                               0
90                                                                                                     0                               0
91                                                                                                     0                               0
92                                                                                                     0                               0
93                                                                                                     0                               0
94                                                                                                     0                               0
95                                                                                                     0                               0
96                                                                                                     0                               0
97                                                                                                     0                               0
98                                                                                                     0                               0
99                                                                                                     0                               0
##                                                                                                     0                               0
                                                                                                       0                               0
4
    PATIENT REPORT
    Practice ID                                       0
    Year end                                      31/03/2012



    Patient name                                      0

    Patient ID                                        0

    Diagnosis                                         0

    Date put on register                          00/01/1900

    Date of completion of initial care plan       00/01/1900

    Date care plan summary sent to out of hours   00/01/1900

    Date of last care plan update                 00/01/1900

    Date of last OOH Summary update               00/01/1900

    Date end of life plan initiated               00/01/1900
Select patient name from menu above
Click 'file', 'print' from the tool bar to print report
Payment Report

Indicator Description                                                                                            Practice       Indicator 2 & 3   Indicator 4
          Practice ID                                                                                        0              0        #DIV/0!                    0
          Period starting date                                                                      01/04/2011
          End of financial year                                                                     31/03/2012

          Number of new cases identified with palliative and end of life care needs,
    1     irrespective of diagnosis, added to the palliative care register in this financial year           0
          Number of patients with a care plan compiled within specified timescale for
    2     inclusion on the palliative care register                                                         0
          Number of patients whose up to date palliative care summary has
          been made available to professionals involved in the out of hours
   3      period within specified time period                                                               0
  2&3     Number where indicator 2 & 3 achieved                                                             0
          Number of patients with a care plan for whom the GP Practice uses a
          recognised system, assessing when patients on the palliative care
          register reach the last days of their life and use an integrated care pathway (e.g.
    4     Liverpool care pathway equivalent)                                                                0
DIRECTED ENHANCED SERVICE (DES)
PCA(M)(2010)20




  Annual Declaration: Directed Enhanced Services (DES): Palliative and End of Life Care



  NHS Board Area
                                                                                                     0                 NHS BOARD

  Practice Reference Number

  Qualifying Year End                               3          1          0           3          2            0         1          2           31
                                                                                                                                             2012



  Number of patients identified with palliative and end of life care needs, irrespective of diagnosis, first
                                                                                                                                    0
  included on the palliative care register from 1st April 2011 to 31st March 2012.


  Analysis of the number of the above:



  Number of patients with a care plan compiled within two weeks of inclusion on the palliative care register and
  whose up to date palliative care summary has been made available to professionals involved in their care in                       0
  the out of hours period within 2 weeks of inclusion in the register.



  Number of patients with a care plan for whom the GP Practice uses a recognised system of assessing when
  patients on the palliative care register reach the last days of their life and work with local systems to an                      0
  integrated care pathway (e.g. Liverpool care pathway or equivalent).




  I declare that the information I have given on this form is correct and complete and I understand that if it is not, action may be taken
  against me. I acknowledge that my claim will be authenticated from appropriate records, and that payment will be made to my
  Practice, which will be subject to Payment Verification. Where Practitioner Services is unable to obtain authentication, I acknowledge
  that the onus is on my Practice to provide documentary evidence to support this claim.


                                                                                             Practice Stamp


  Signed




  Date…………………………………



Please return completed forms as advised by your boards

								
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