1. Atrial Fibrillation Project, SSNAP July to September 2013 and QOF Indicators 2012/2013
South Kent Coast CCG

2. South East Coast SCN -Atrial Fibrillation Project
Earlier detection and anticoagulation optimisation of patients with atrial fibrillation
First step will be agreement on recommendation of NICE anticoagulation guidelines as best practice. New NICE Guidance will be published on the 11th June 2014
Task to Finish Group being established to implement the NICE guidance
Will be followed by the development of a best practice model for earlier detection and management
SSNAP Data – July to September 2013 most up to date
QOF Data from 2012/13 most up to date
Uses CHADS2 scoring. This will be replaced by CHADSVASC in NICE Guidance

3. SSNAP Data – July to September 2013
Nationally 19.8% of Stroke patients had previous AF. SEC is 20.5 %.Range in SEC is 12.7 to 35.5%
Best practice is anticoagulant prescribing for AF
Nationally 24.5% of Stroke patients with AF were not previously prescribed anticoagulants or anti-platelets. SEC is 26.8%. Range is 7.7 % to 40%
Nationally 32.5 % of Stroke patients with AF were previously prescribed anticoagulants only. SEC is 31.4%. Range is 0 – 70%

4. SSNAP Data – July to September 2013

7. QOF Atrial Fibrillation Indicators – 2012/13 by CCG
Four Indicators
Prevalence (percentage on QOF AF Register/practice population)
AF05 – Percentage on AF register who have had a CHADS2 score in the previous 15 months (except those whose previous score was greater than 1)
AF06 – In those with a CHADS2 score higher than 1 in last 15 months– those who are on anti-coagulants or anti-platelets (minus exceptions)
AF07 – In those with a CHADS2 score higher than 1 in last 15 months – those who are on anti-coagulants (minus exceptions)
Any correlation between QOF CCG indicator results and AF stroke admissions and prescribing? E.g. High stroke admissions with AF in local hospitals and low anticoagulant prescribing for those admissions and low prevalence and low anticoagulant prescribing (for the known AF’s) in CCG data

8. AF Prevalence by CCG in Kent

9. AF05 by CCG in Kent

10. AF06 by CCG in Kent

11. AF07 by CCG in Kent

12. QOF Atrial Fibrillation Indicators – 2012/13 by Practice
What to look for
Does the prevalence look low for this practice population and demographics? All other indicators are based on this. Low numbers may mean that some AF patients have not been diagnosed
AF05 – Low rates will indicate that the practice isn’t routinely assessing those on the AF Register for CHADS2 and changes to their risk
AF06 – Best practice is for those with identified AF to be on anticoagulant therapy not anti-platelet therapy. Compare rates with AFO7. High rates on AF06 but lower rates on AF07 indicates a high usage of anti-platelet therapy .
AF07 - Best practice is for those with identified AF to be on anticoagulant therapy . Compare with prevalence and AF05 - high rates but low prevalence and low routine assessment may indicate that only small numbers are being managed well

13. GP Practice Codes in South Kent Coast CCG
AYLESHAM PRACTICE
G82111
CEDARS SURGERY-DEAL
G82007
CHURCH LANE SURGERY
G82818
DOVER MEDICAL PRACTICE
G82217
DR AMIN Y Y
G82700
DR BAHADUR T
G82760
DR BANIK A N & PARTNER
G82665
DR CAWDRON B A
G82072
DR DOWNIE P L
G82232
DR FERNANDES M A A
G82696
DR FORD M R
G82091
DR HOSSAIN M A & PARTNERS
G82069
DR JEDRZEJEWSKI J A & PARTNERS
G82015
DR MOTTERSHEAD A C & PARTNERS
G82036
DR SHARVILL N J & PARTNERS
G82227
DR WRIGHT L M & PARTNER
G82187
FOLKESTONE EAST FAMILY PRACTICE
G82165
HAWKINGE AND ELHAM
G82684
NEW LYMINGE SURGERY
G82147
OAK HALL SURGERY
G82160
OAKLANDS HEALTH CENTRE
G82662
PENCESTER HEALTH
G82128
PETER STREET SURGERY
G82121
SANDGATE SURGERY
G82002
ST JAMES SURGERY
G82038
ST RICHARDS ROAD SURGERY
G82018
SUN LANE SURGERY
G82117
THE HIGH STREET SURGERY
G82086
THE NEW SURGERY
G82652
THE SURGERY
G82729
WHITE CLIFFS MEDICAL CENTRE

14. Prevalence by Practice compared to KSS (Red line) and England (Green Line)

15. AFO5 by Practice compared to KSS (Red line) and England (Green Line)

16. AFO6 by Practice compared to KSS (Red line) and England (Green Line)

17. AFO7 by Practice compared to KSS (Red line) and England (Green Line)