Having an up to date and accurate Learning Disability Register is a essential.
QOF requires the practice to create and maintain ‘a register of patients with LD’ with no ‘age of patient’ parameters set. However, the LD Health Check Scheme (DES) states ‘a requirement that the contractor (practice) set(s) up and agrees with the Board (NHS England or the CCG) a “health check learning disabilities” register for the purpose of identifying those of its registered patients aged 14 years or over with learning disabilities who are to be invited for an annual health check under the arrangement (the DES). These patients should also be offered the free influenza vaccine.
Coding is key to ensuring that people with learning disabilities are not only included on the QOF Learning Disability Register but your practices Learning Disability Register as well. Every patient who has a learning disability must have the “On the Learning Disability Register” code to ensure patients are on both Learning Disability registers. If patients are coded with a particular syndrome, for example, Down’s syndrome these codes will not pull the patient onto your practices Learning Disability register. In this example the patient should have the Down’s syndrome code and On the Learning Disability Register code.
The codes for On the Learning Disability Register are:
System One/ TPP code: XaKYb EMIS code: 918e SNOMED: 416075005
Tip: When new patients register check they have been coded correctly and should be on the Learning Disability register. To maintain an accurate and up to date register review it regularly.
Identifying whether someone meets the eligibility of having a learning disability is not just reliant on a cognitive assessment. Often people with learning disabilities have never had a cognitive assessment. It is important, when establishing whether someone has a learning disability or not to look at the patient’s general day to day functioning, employment, schooling and so forth. The Learning Disability inclusion Tool (Leeds CCG) helps you to gather this information and reach a decision.
NHS England & NHS Improvement also published a guidance on Improving identification of people with a learning disability so please review this as necessary.
Contact your local Community Learning Disability Team if you are unsure if a patient does or does not have a learning disability.
Please note Community Learning Disability Teams are not commissioned to assess patient’s cognitive ability unless the patient has an adapted clinical health need(s) the service is commissioned to provide.
When submitting your LD register size on CQRS please try to ensure you are submitting the total number of eligible patients aged 14 years+.