If you find your Mental Health patient won't "go green" on QOF Timeline no matter how many times you add a MHP code (Code for Mental health care plan) such as 'Review of mental health care plan (867871000000100)' - they probably don't need one. There's likely a data quality issue with the diagnosis and remission history.

Background

MH diagnoses require the start of each episode to be marked 'New episode' - if this episodicity is missing, subsequent entries of MH remission codes will not work correctly and the patient will still appear in QOF MH indicators when they should only be on the MH register.

You can use the QOF Alerts & Analysis node to help check this with the Clinical Data by Code Cluster tab.

Example

George was diagnosed with 'Bipolar disorder' in 1982. In 1995, George's specialist confirmed he has been symptomatically in remission for over 5 years and so no longer requires active monitoring.

Unfortunately the original diagnosis is missing the necessary episodicity, so QOF incorrectly believes George needs the full suite of MH indicators completed. The indicators on QOF Timeline are red, prompting staff to complete work unnecessarily:

Having spotted the missing episodicity from the original diagnosis, we can easily add this. On the QOF Alerts & Analysis screen this will display as an icon. On the Journal entry, there will instead be the text "(New Episode)" next to the code.

The start of the episode is now correctly marked 'New episode' and George is correctly exempt from MH QOF indicators (grey on QOF Timeline). He will remain on the MH register indefinitely in case of a relapse.

Multiple episodes

If a patient has had multiple episodes of a condition, or multiple conditions, the start of each episode will need to be marked 'New episode':

Duplicate/repeating diagnoses during an episode

Where a diagnosis has been re-added/duplicated during an episode, these can either have no episodicity or be marked 'Ongoing episode'; however, this is for record clarity, this will not impact QOF as long as there is a suitable starting diagnosis marked 'New episode' and a subsequent remission code. Below the duplicate diagnoses in Dec 1982 and Apr 1984 have been marked 'Ongoing episode' (blue arrow).