▸ Update coding (disease registers, QOF data)

▸ ‘Review of records revealed that DVT and pre-eclampsia had not been coded as active significant problems. Codes added to records’ (HBA)

▸ The patient in PSI X has had his coding corrected and he is now on the QOF register again (HBB)

▸ Updated missed read code for patient with aortic valve replacement (HBB)

▸ Correct coding/records

▸ ‘[I] spotted a couple of coding errors and also an entry that had clearly been made in the wrong set of notes. These were addressed as I went along’ (HBA)

▸ ‘Incorrect Heart Failure code removed. Adverse reaction to ACE recorded’ (HBA)

▸ Some codes have had priority level changed (HBB)

▸ The patient’s GP record has been amended to remove the incorrect code for bladder cancer (HBB)

▸ Add a clinical entry or set a task ‘reminder’ or ‘recall’

▸ ‘Yellow flag reminder added regarding methadone’ (HBA)

▸ Changes to medication items (commence new drugs, change or discontinue current drugs)

▸ ‘During the review I reviewed repeat medications. I looked at when medications were last requested. I deleted medications that had not been requested for some time’ (HBA)

▸ Stopped inappropriate anti-emetic (HBB)

▸ Perform medication reviews

▸ ‘Medication reviewed to ensure appropriateness of prescriptions’ (HBA)

▸ Where it was felt appropriate to remove medication that had not recently been requested from the repeat medication list, this was done. (HBB)

▸ Clarify management plan and who is responsible for delivery with secondary care

▸ ‘For DNA hospital appointments [we] ensured patients had received appointments from hospital. Also ensured addresses/contact details for patients are up to date’ (HBA)

▸ Contact was made with the hospital re missing A&E admission paperwork for patient (HBB)

▸ Clarify patients’ understanding of their management plan

▸ ‘In the first patient, his repeat medication was updated after speaking to him on the phone’ (HBA)

▸ ‘Two patients[were] contacted to clarify prescribing doses’ (HBA)

▸ Contact made with the patient identified as having numerous contacts with out of hours. Discussed this behaviour, emphasised the importance of not abusing this service and encouraged the patient to contact the surgery during normal opening hours if there is a problem. (HBB)

▸ Providing information or educating patients

▸ ‘[I] informed patient to stop Aspirin one week before next hospital appointment’ (HBA)

▸ Medications were updated and discussed with patients during immediate discharge medicines reconciliation (HBB)

▸ Confirming that intended actions (eg, scheduled monitoring) took place

▸ ‘[I] phoned anti-coag clinic to check INR recently done’ (HBA)

▸ ‘[I] ensured housebound patients on DMARDs are monitored as per guidelines’ (HBA)

▸ Patient having monthly DMARD bloods—phoned rheumatology nurses to check if it should be 4 or 8 weekly (HBB)

▸ Arrange an appointment with the reviewing clinician or another practice team member

▸ ‘I invited a patient with CKD to attend for BP which is overdue’ (HBA)

▸ ‘Patient in PSI3[were] phoned and asked to make an appointment to see GP’ (HBA)

▸ One patient who was overdue monitoring and not responded to letters has had methotrexate removed from repeat and a nurse telephone call booked to discuss (HBB)

▸ Refer to another healthcare provider

▸ ‘[I sent a] letter to Cardiology about this patients AF diagnosis and CHADS recommendation’ (HBA)

▸ Arrange additional investigations for a patient

▸ ‘Two patients on diuretics and ACE with no U&Es in last year invited for U&E[check].

▸ One patient with Hb=9.2 and no recheck for a year recalled for blood test’

▸ (HBA)

▸ Patient was lettered to attend GP for medication review and monitoring bloods to be performed.

▸ (HBB)