Richard Gunn – Project Manager National CKD Audit Richard Gunn – Project Manager

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Audit Overview Commissioned by HQIP on behalf of NHS England & Welsh Government. Delivers an audit of national prevalence and CKD Management with quality improvement tools for practices. Format of Audit cycle Baseline snapshot, Minimum 3 months, Snapshot for reporting. Reports late 2016. Practices receive practice identifiable reports. CCG/LHBs receive area reports, and have access to practice reports. National report.

Audit Aims Improve identification of CKD in primary care Increase coding Improve testing of ‘at risk’ groups Develop QI tools for diagnosis and staging Improve management of CKD patients not requiring specialist review Audit against NICE targets (e.g. BP, CV risk assessment, CKD monitoring) Develop QI tools for primary care management Improve timely referral of CKD patient requiring specialist review Audit referrals through HES linkage Snapshot of referral pathways across CCGs

Data Management – via Audit+ Not part of Care.Data. Data extract requires initial practice agreement but is then fully autonomous. BMJ Informatica has received Section 251 Approval to extract data without explicit patient consent. Research partners only receive pseudonymised data. Patients can opt out via GP practice or by contacting the National Audit Team. Existing opt-out codes are respected by the audit.

Dashboard display – shows coding status of the practice Dashboard display – shows coding status of the practice. Coded/uncoded/miscoded Prevalence is age/sex corrected Uncoded patients with possible CKD according to eGFR. This shows people who are not already coded as CKD 3-5 but who have eGFR evidence of CKD. Patients with risk factors for CKD. These are people who do not have CKD coded but do have defined risk factors for CKD (e.g. Diabetes, Hypertension, Vascular Disease or who have taken certain drugs recently) and so should be being checked regularly. Potentially miscoded patients. These are patients coded as CKD 3-5 where they do not have eGFR evidence of CKD.

Lists of patients that can be used for call/recall or for systematic review. Automatically updated every night (no practice action needed)

Prompts are available – uncoded patients is the only one switched on by default

A BP above the recommended range ;or Dashboard showing management status of the practice for high and lower risk patients Patients with CKD at Higher Risk. These are people coded CKD 3-5 who also have diabetes or proteinuria and A BP above the recommended range ;or Have not had an eGFR in the last 12 months; or Have not had an Albumin/Creatinine Ratio or a Protein/Creatinine ratio checked in the last 12 months. Patients with CKD at lower risk. This is the same as above but the people do not have diabetes or proteinuria.

High Risk patients with missing management activity or values out of range.

Audit Tool Deployment Existing BMJ Informatica customers can opt in now. Other users can sign up via the website but rollout dependant on GPSOC process.

Contact & More Info Web: www.ckdaudit.org.uk Email: nationalckdaudit@bmj.com