Disease registers
Disease registers are held in primary care and should be accurate and proactively used to improve the care of people with COPD by guiding ongoing treatment and management. However, anecdotally it is widely acknowledged and there is evidence from NHS Improvement - Lung projects to demonstrate that most registers are far from accurate and therefore can not be used to proactively manage a patient with COPD.
Accuracy is further compounded by variation in the information that is included on local GP templates. The consultation COPD strategy suggests what should be included in a register which is over and above Quality and Outcome Framework (QOF) requirements.
If accurate and used proactively and systematically, registers could become a richer source of information in gauging the progression of the disease and the impact on the health economy, ensuring treatment pathways are appropriate and that people are given appropriate support and advice.
NHS Improvement - Lung has been working with three projects to review and develop COPD registers to improve quality and patient outcomes. The Joint North East London, North Central London and Essex HIEC and Hammersmith and Fulham PCT have been reviewing the accuracy of registers and Leeds Teaching Hospitals have developed a register to be used in both primary and secondary care.
Top tips for an accurate disease register:
- review guidelines regarding the content of a register
- understand how the register information is used and extracted
- produce a process map of how patients are currently added to the register
- how are patients added to the register
- who adds patients to the register
- what information is added to the register
- which read codes are used
- do all staff have the same templates on the practice computers
- does everyone do the same thing
- have a robust mechanism to ensure healthcare professionals deliver accurate quality-assured diagnosis
- document and train staff in a standardised process for adding, retrieving and updating information on the Disease Register
- educate staff in the importance of an accurate diagnosis and register
- plan small audits to review the registers until the process of all patients being accurately added to the COPD register is embedded and sustained in the practice culture
More information
For more information about accurate diagnosis, please contact:
Zoe Lord
National Improvement Lead
Lung Improvement Programme
NHS Improvement
Mobile: 0772 176 1744
Email: zoe.lord@improvement.nhs.uk