1. Atrial Fibrillation Project, SSNAP July to September 2013 and QOF Indicators 2012/2013
North West Surrey 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 Surrey

9. AF05 by CCG in Surrey

10. AF06 by CCG in Surrey

11. AF07 by CCG in Surrey

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 North West Surrey CCG
PARISHES BRIDGE MEDICAL PRACTICE
H81004
SHEPPERTON MEDICAL PRACTICE
H81041
SOUTHVIEW MEDICAL CENTRE
H81087
ST DAVID'S FAMILY PRACTICE
H81025
ST JOHNS FAMILY PRACTICE
H81134
STAINES HEALTH GROUP
H81079
STAINES THAMESIDE MEDICAL
H81104
STANWELL ROAD SURGERY
H81009
STUDHOLME MEDICAL CENTRE
H81042
THE CROUCH OAK FAMILY PRACTICE
H81020
THE FORT HOUSE SURGERY
H81066
THE GROVE MEDICAL CENTRE
H81093
THE HEALTH CENTRE
H81632
THE ORCHARD SURGERY
H81641
THE PRACTICE COLLEGE ROAD
H81094
THE RED PRACTICE WALTON
H81050
WEY FAMILY PRACTICE
Y02688
ASHFORD HEALTH CENTRE
H81015
CHOBHAM & WEST END MEDICAL PRACTICE
H81073
CHURCH STREET PRACTICE
H81003
DR BARNETT AND PARTNERS
H81065
DR C C NOON & PARTNERS
H81095
DR D M NGUYEN
H81007
DR E DE SOUSA AND PARTNERS
H81642
DR G W KAMIL
H81033
DR H G TOWIE AND PARTNERS
H81663
DR L J DELAIMY
H81019
DR M BOURKE & PARTNERS
H81123
DR M S MOHAMED
H81122
DR M SALAHUDDIN
H81054
DR NORTH-COOMBES AND PARTNERS
H81061
DR P J R SMITH & PARTNERS
H81111
DR P LOXTON AND PARTNERS
H81664
DR R J POOL
H81131
DR S MORCOS
H81129
DR VAN DEN BOSCH & PARTNER
H81024
DR Y D COLLINS & PARTNERS
H81643
DR YUSUF & PARTNER
H81057
FORDBRIDGE MEDICAL CENTRE
H81032
HEATHCOT MEDICAL PRACTICE
H81002
KNOWLE GREEN MEDICAL
H81034
LYNCH MEDICAL CENTRE
H81658
OTTERSHAW SURGERY

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)