Helpline Blog Archive July 2009

An issue has arisen whereby users may get blank Worklists when opening the Choose and Book website. ATOS have provided the following fix which, when applied, will remedy the situation.

Please note that this is a per workstation/ profile, so you may need to apply it on more than one machine.

To apply the fix:

• Close all Internet Explorer windows.
• Open up a new Internet Explorer window
• Select Tools -> Internet Options
• Within the Internet options screen, navigate to the Security tab. 
• Click on Trusted Sites, then click the Sites button below it
• The website (https://nww.ebs.ncrs.nhs.uk) must be visible under the web sites section. If this is not present, please add it, and ensure the Require server verification (https:) for all sites in this zone option is ticked
• If you get a message "The site you specified already exists in another zone. Please remove the site from that zone before adding it to the current zone" - this means the nhs.uk domain has already been added. Proceed to the next step.
• Click OK (Trusted sites box will close)
• Click Apply on Internet Option box
• Still under Trusted sites, click the Custom Level button
• Scroll down the list until you reach the Miscellaneous section. Scroll a little further down the list until you see the option for Navigate sub-frames across different domains. Please ensure this option is selected to Enabled.
• Click OK on the security setting box
• Click Apply and OK on Internet Option box
• Close down Internet Explorer, open up a new instance, and log into CaB. CaB should be working as normal.

To download these instructions as a Word document, complete with screenshots, please follow this link.

Guidelines for the V14 business rules with the new domains for Sexual Health and Primary Prevention of CVD are now available for download. The guidelines also include updated templates for the DES England 2008-10. You are strongly advised to read the user guide and follow the instructions for deletion of ALL previous versions of these guidelines.

Please click here to download the Guideline and User Guide.

A new set of revised Vision 3 Training Guides have just been published. You can find them by clicking on the Training Guide link on the menubar at the top of the page.

A new suite of audits for England Directed Enhanced Services are now available for download. They are:

• Reporting for Alcohol DES (version 12009, 05/06/2009)
• Reporting for Ethnicity DES (version 12009, 05/06/2009)
• Reporting for HF DES (version 12009, 05/06/2009)
• Reporting for Learning Disabilities DES (version 12009, 05/06/2009)
• Reporting for Osteoporosis DES (version 12009, 05/06/2009)

You can download the audits from the Clinical Audit section of the www.inps.co.uk website, or by clicking here.

The Helpline Blog now has additional functionality to make it easier for you to locate older blog articles.

On the right-hand menu you will find links which allow you to filter results by the category they were posted in (e.g. Drug Dictionary, Guidelines, Clinical Audit, etc). Alternatively you can search by the month in which the article was posted.

You can also use the "search INPS" box towards the top right of the webpage.

We have also added an RSS feed. This is an excellent way to keep up to date with new content published on the blog without having to keep checking it for updates. There are many news readers available which you can use to view the feed in, but perhaps the most commonly used is Outlook 2007, which has this feature built in.

Please note that earlier versions of Outlook do not support RSS.

To subscribe to the Helpline Blog RSS feed using Outlook 2007, follow the instructions in this document.

We hope that you will find these new features to be of use.

Please note that these instructions are not required for sites on Hosted Systems, as the patch will be applied for you by the VES Team at INPS.

Download the Pathology Bounded Code List Patch here

Download the Instructions for Installing the Pathology Bounded Code List Patch here

Following requests from a number of practices INPS have written a small guideline that pulls together the leaflets and websites where you can find useful information about Swine Flu, Influenza A(H1N1).

The name of ‘Ensure Plus Ready to Hang’ is changing to ‘Osmolite 1.5kcal’. The 1500ml pack size will be the first presentation available under the new name. The 500ml and 1000ml presentations will change over the following months. The product records on Multilex DDF will be changed accordingly. There have been no changes made to the actual products and they have the same nutritional content.

After rigorous testing and discussions with all four countries regarding the End of Year Recovery plan, INPS are pleased to announce that an update is now ready to be run by practices in order to assess whether or not they require an adjustment to the QOF Submission.

The update is different for location (England, NI, Scotland and Wales) and depends on whether you have your own server or are on a managed server. Please choose your country and you will be taken to the instructions and files required.

SurgerySoft have developed a limited edition of their QOFcountdown Excel Spreadsheet that is available to be downloaded and will allow each practice to compare their original submission with the new, corrected interim report before deciding on a request for adjustment.

Please click on the relevant link for the country you are in:

England

Scotland

Wales

Northern Ireland

The Data Services team are currently testing the fix on a small number of sites prior to getting agreement from CfH to release to all practices. Helpline CANNOT help practices with the fix at the moment until the testing is complete. The fix will be published on the website as soon as we are able. This will involve running an interim audit and submitting the report from this manually to your PCT and asking them to manually amend your submission prior to payment. We will be providing a spreadsheet which will display the changes between the End of Year submission and the interim to make this easier for the practices and the PCTs.

The processes for Wales, NI and Scotland will be different so please await instructions.

Following the QMAS transmission on 31st March 2009 INPS were made aware by practices that there seemed to be an error in figures reported to  QMAS. The error is apparent in any audit line where registration dates and dates of birth are calculated to Reference Date, where the program mistakenly calculates these  figures to next year’s Reference Date of 1st April 2010. This issue was not apparent during the extensive testing both before and after conformance of the audits and has been difficult to isolate even now.

We spent most of the day yesterday investigating the extent of the problem and trying to assess the implications for each practice, but INPS deeply regret that it is likely that ALL INPS sites will be affected by this and the data on any practice’s  monthly submission could be incorrect. The level of inaccuracy in the figures will have dependencies on practice size, population turnover and demographics.

We are talking to the QMAS/PCAS/CMWeb teams in England/Scotland/Wales/Northern Ireland and will be negotiating with your PCT/LHB/HB as to how this situation is best managed.

In the meantime we would advise all practices that their QOF submission is NOT signed off until a fix and resolution is available.

If you have already signed off QMAS,  you should contact your PCT/LHB/HB and advise them that your figures may be incorrect, and apply for an adjustment. This can be done once INPS have provided the fix and an interim report with the correct figures has been run..

When checking your figures in Clinical Audit for the year end report please remember the following …

• The ‘Last Reported’ drop down view in Clinical Audit will show details of the last message sent to QMAS.
• You can check the message has been sent by looking at the ‘QOF Reporting’ tab at the bottom of Clinical Audit. In there you should see a button to ‘View Results’ in the ‘Monthly’ frame. Viewing these results should show all the months data including March, this report can be printed by right mouse click and choose “Print” .This means the end of year message has been generated.
• The ‘nGMS Reporting’ and ‘All Audits & nGMS Monitoring’ will show figures for next year if the generation has been run today.
• If you have any discrepancies in clinical audit and need to raise this with Helpline please specify the patients involved wherever possible. This will assist us in determining the cause of the problem as quickly as possible.
  

INPS are aware of a problem that many sites are encountering in that the report which has been sent to QMAS appears to be failing to count those patients who have been registered with the practice in the last 3 months. We are working on a fix for this and will be posting here on  the INPS website with full instructions as soon as it is tested and ready for use.

We are very sorry  for the  difficulties this has caused particularly at this very stressful time.

Please bear in mind that the nGMS financial year ended on the 31st March (yesterday). The figures in the nGMS Reporting tab which you can now see are based (as of today) on the new financial year, which has a Reference date of 1st April 2010.

Please note: Having received notification from the relevant authorities, this now applies to ALL PRACTICES in ENGLAND, WALES, SCOTLAND AND NORTHERN IRELAND. If you are on one of the managed servers, you do not need to take any action as will will do this for you.

Please pass this to your Computer Manager, it requires your immediate attention

Connecting for Health have requested that all suppliers make changes to their systems to enable practices to report to QMAS for the changes to RECORDS23 and PC03 that the Department of Health have insisted be rectified by the end of the financial year.

From the bulletin:

Records 23 (Ex Smoker)

We are aware that there is an issue with records 23. This issue relates to non-smokers aged 25 and under and ex-smokers being required to have their status recorded within 15 months in the current business rules. The indicator requires smoking status to be recorded within the last 27 months. The business rules for 2009/10 will be amended to ensure that smoking status under this indicator is only required to be recorded within the last 27 months.

PC03

We are aware that there is an issue when checking the palliative care register (PC03). Currently the business rule states that the register contains patients for 3 years rather than the previous 12 months. This discrepancy will not affect payments as there is no prevalence adjustment for the palliative care register, but it will be corrected in the next set of business rules.

INPS have written an audit which can be imported into your Clinical Audit by running an interim report, please go to the website here to download the audit and user guide.

When you have imported the audit it is important that you let INPS know so that we in turn can inform CfH and your PCT so that you are correctly paid for these two domains.

Fill in the survey here with the Version and Date of the audit you have just imported, this is the dark blue data in brackets at the end of each audit domain title.

An update to the nGMS guidelines has been made to incorporate changes to the business rules in V13. This also includes the changes to Records 23 as stated in the February 09 bulletin from CFH and some additional spoken language codes in the Ethnicity DES section. The guideline can be downloaded from http://www.inps4.co.uk/my_vision/guidelines/

DLM 275

We have identified an issue with DLM 275 where Clinical Audit shows different versions of the nGMS Contract audits for the Monitoring and Reporting views. The nGMS Monitoring view has been correctly updated to V13004 nGMS Contract audit (V12010 for Scotland) but nGMS Reporting view has not been updated and is still showing results for the previous V12008. Note that some early DLM275 alpha practices will show nGMS Reporting as V13003. As a result of this problem, your reporting reminders may not be correct.

Your QOF Reports submitted to QMAS (England), PCAS (N Ireland) and CMWeb (Wales) are being correctly sent as version 13, based on the nGMS Monitoring version. For Scotland, they are being sent as the correct V12 format.

A program that will resolve this issue will be put on the INPS website in the next few days. Instructions will be provided for you to download and run the program without the need for you to call the helpline. We will send you an email update as soon as this has been made available.

As you will be aware the changes between V12 and V13 Business are fairly minor with the main differences summarised by clicking here.

We apologise for any inconvenience this problem causes.

Interchange Numbers

DLM 272 resolved a Pathology issue introduced in DLM 265. However a secondary issue with the delivery of EDI messages has now been identified at a number of practices. Where this occurs there will be missing interchange numbers in GPC and it is therefore very important that practices regularly check for missing interchange numbers. This should be a regular task for practices but in investigating this problem it has become apparent that some practices are not doing this.

We would urge all practices to continue regularly checking in GP Communicator for missing interchange numbers not only for Pathology but for Registrations and, where used, IOS. Where these interchanges are missing please ask the sending party to resend the message so it can be processed correctly.

DLM 276

DLM 276 is expected to start on-site testing next week. This is a minor release which resolves a problem with EDI messaging which is affecting some practices.

Choose and Book FAQ

Helpline have put together a new Helpsheet that details the most frequent calls about Choose and Book that they receive. You can download this helpsheet by clicking here.

Helpline Bulletins

We intend to send this Bulletin to practices on a regular basis to ensure practices are aware of known problems, helpline issues and DLM progress. If there are other practice staff who would like to receive this bulletin please email helpline@inps.co.uk

Make sure you regularly check the 'My Vision' section of the INPS website for the latest information.

There were changes made to some products with the December Multilex dictionary.  These changes have resulted in a number of items that require the number of mls to be calculated rather than a number of tetrapacks, bottles, etc. 

Although a number of practices have complained, and we have asked for this be be reversed, First Databank are not able to do so for a number of reasons.  However, to get around this problem, there is a little known calculator facility available in the Quantity field.  For example, if you type 6*30*220 (ie 6 packs per day for a month), it will calculate 39600 for you after you tab to another field.

Snow Disruption

The heavy snow caused travel chaos in London this week. With the bus, train and road networks shutdown this meant that only the very few Helpline staff within walking distance could get into the office. To ensure those users with urgent issues could receive prompt attention we decided not to open the phone lines and operated an email only service on Monday and Tuesday. This allowed most Helpline staff to work from home which operated very efficiently and on Tuesday we logged 612 incidents via the web and closed 630 logs. We apologise for any inconvenience the lack of phones caused.

DLMs

DLM 272 is now rolled out to nearly all practices. This release has resolved the problem of certain pathology results not filing into the patient record. The program to file those results that have not been filed prior to DLM 272 is now in testing and will be included in DLM 280.
DLM 275 contains QoF Ruleset 13 and goes to alpha testing at 5 practices on 10th February. The user guide for DLM 275 can be downloaded by clicking here.

INPS Escalation Process

We have updated the process document that explains what you should do if you need to escalate a helpline or other service issue.
The document can be downloaded by clicking here.

Helpline Bulletins

We distirbute this Bulletin to practices on a weekly basis to ensure practices are aware of known problems, helpline issues and DLM progress.

If there are other practice staff who would like to receive this bulletin please email marketing@inps.co.uk

QOF Ruleset 13

QoF Ruleset 13 will be released in DLM 275. The DLM 275 user guide includes the rule changes in QOF 13 and is now available to download from the website by clicking here.

DLM 275 will follow DLM 272 and will be released to all practices as soon as the QMAS system is updated by CFH to the new Ruleset in February. 

Clinical Audit

Helpline are still receiving quite a number of calls from practices not understanding the new nGMS contract views in Clinical Audit. INPS has created a helpsheet on this topic which can be downloaded by clicking here. 

DLM 272

This release addresses the problem where certain pathology results are failing to be filed into the patient record following a Codebase 69 error. This release is now being distributed to all practices over the next few days.

We are in the process of writing a utility which will automatically file any pathology messages that have not been filed into the patient record because of the above error. This will be released in a future DLM as is not ready to be released as part of DLM 272 and stopping the problem occurring in the first place is our main priority. 

V13 Smoking Guidance

In addition to previous resources, we have provided a flow chart for SMOKING 03 and RECORDS 23 numerator rules. This should enable you to look at a patient and follow the questions to see which (if any) data is missing to put the patient in the numerator. This document can be downloaded here.

Helpline Bulletins

We intend to send this Bulletin to practices on a weekly basis to ensure practices are aware of known problems, helpline issues and DLM progress. If there are other practice staff who would like to receive this bulletin please click here to fill out the online form.

For previous Helpline Support Bulletin please click here.

The 10mg, 15mg and 25mg versions of "NICORETTE INVISI patch" were added with the dataset received by INPS from FirstDataBank (the supplier of our Mulitlex dictionary) earlier this week.  This dictionary is currently in testing and should be released to our end users in the coming weeks.

Pathology Problem

DLM 272 is now in the beta phase of release. This release addresses the problem where certain pathology results are failing to be filed into the patient record following a Codebase 69 error. Further information on this release will be sent out before we commence distribution.

Vision Performance Survey

We have not received many responses to our survey on whether Vision performance has improved since DLM 270. We would really appreciate you spending a few moments to complete the survey as knowing whether DLM 270 is faster than DLM 265 will help us plan further performance improvements in the next few months. The online survey will take less than 5 minutes to complete by clicking here.

QoF v12 Ruleset and Clinical Audit

QoF Ruleset v12 has now been distributed as part of DLM 271.

Helpline has been receiving a very large volume of calls regarding:

QoF Smoking 3 and Records 2 indicators click here for more information

QoF BP05 Negative click here for more information

Clinical Audit Reminders - If your practice uses Clinical Audit Reminders, make sure that the 'Generate Reminders' option is enabled in Mail Gateway - Schedule, or GP Communicator - Tools, Options. This is will ensure that patient reminders are always automatically up to date with the latest Clinical Audit results.

New QoF Audit views click here for more information

Helpline Bulletins

We intend to send this Bulletin to practices on a weekly basis to ensure practices are aware of known problems, helpline issues and DLM progress. If there are other practice staff who would like to receive this bulletin please click here to fill out the online form

Dear Vision User,

We will tonight commence full scale distribution of DLM 271. This update introduces the v12 QOF Business Rules and includes some bug fixes to the Clinical Audit functionality introduced in DLM 270.
 
This release includes:

• QOF V12 Business Rules
• Daily Generation of QOF audits
• Automatic removal of "QOF v12 temporary audits" if they have previously been manually installed
• Several minor bug fixes in Clinical Audit

We are aware of one outstanding issue with DLM 271, which may affect a minority of practices. If your site is set up to run an automatic nightly clinical audit generation but also has "exclusion times" and if your clinical audit generation is incorrectly set to run within those exclusion periods, you may find that some historical data is missing from your "Prevalence" tab in clinical audit following the installation of DLM 271.
 
You can check or amend your schedules in Mail Gateway by clicking the "Schedule" button midway down the right hand side of the window.   Amend or disable any Clinical Audit generation schedules that are set within the exclusion times that will show on the right of the subsequent window.    
 
Should you experience this problem with missing prevalence data, then an advanced generate should be run within the Clinical Audit application which will restore this missing data.   This can be run whilst others are signed into and using Vision.  
 
We apologise for any inconvenience that this issue may cause you but as there is an urgent need to distribute the updated V12 Business rules and enable the daily audit generation runs we have decided to release this software at the earliest opportunity.

YOU HAVE RECEIVED THIS EMAIL BECAUSE YOU ARE ON THE INPS HELPLINE DISTRIBUTION LIST.

Regards

Vision Helpline

Dear Vision User,

Vision Performance Survey 

As most practices are now on DLM 270 we would really appreciate your feedback on how this has affected the performance of your Vision system. Please take a few moments to complete the survey by clicking here. Don’t worry if you are not yet on DLM 270 as you will get another opportunity to take the survey in the new year. 

Pathology Problem 

Although we have continued to make every effort to resolve the Codebase 69 problem we are still not in a position to release a permanent fix. We do fully understand the serious impact of this fault and as soon as we have a fix we will release this as DLM 272.

We will email all practices as soon as we have more information on this problem.

QoF v12 Ruleset and Clinical Audit

We are now piloting the final build of DLM 271 which includes QoF Ruleset 12 and the fixes to Clinical Audit included in the last newsletter. As long as piloting the software is as expected we aim to make DLM 271 available to all practices before the end of the year. We will issue a further communication on this before we begin general distribution so practices are aware of the change.

Helpline Opening Hours for Christmas

The Helpline will be open for the following hours over the Christmas period.

Wednesday 24th December 7am to 7pm
Thursday 25th December Closed
Friday 26th December Closed
Saturday 27th December 9am to 1pm
Sunday 28th December Closed
Monday 29th December 7am to 7pm
Tuesday 30th December 7am to 7pm
Wednesday 31st December 7am to 7pm
Thursday 1st January Closed
Friday 2nd January 7am to 7pm

DXS

DXS have identified a problem with their database content which causes Consultation Manager to hang for several seconds when entering certain read codes. This problem occurs for LAN and VES (hosted) practices with version 4.0.2 of DXS installed on their systems. To resolve this problem, users need to have version 4.1 of DXS installed and LAN users should contact the DXS Helpdesk by emailing Support-uk@dxs-systems.com to carry this out. INPS VES users will be upgraded to version 4.1 of DXS over the next few days.

DXS have also identified a problem for a small number of users who have been running DXS and GP2GP in England. The GP2GP record transfer service often results in the accumulation of a large number staff records. When DXS is installed, it imports all of these records into its database which causes the initial load of Consultation Manager to be slow. The DXS Helpdesk have a fix for this problem and LAN based users should contact their helpdesk directly by emailing Support-uk@dxs-systems.com INPS VES users will have the fix applied for them in the next few days.

How to put a backup job on hold

At this time of year we often get requests as to how to stop the backup from running - for example, if the surgery is closed over the Bank Holiday weekend and no one is present to insert a tape for the backup. Click here to download a Helpsheet on how to do this.

Helpline Bulletins

We intend to send this Bulletin to practices on a weekly basis to ensure practices are aware of known problems, helpline issues and DLM progress. If there are other practice staff who would like to receive this bulletin please click here to fill out the online form

Make sure you regularly check the My Vision section of the INPS website for the latest information.

YOU HAVE RECEIVED THIS EMAIL BECAUSE YOU ARE ON THE INPS HELPLINE DISTRIBUTION LIST.

Regards

Vision Helpline

Vision Performance Update
 
We are now well advanced in the rollout of DLM 270 to practices. Feedback from many practices is that patient select and patient load times have decreased in some cases by 5020Audit%20Problems_Dec08.pdf">Click here to download the Helpsheet.

Note that the fix to enable automated daily generation is included in DLM 271.
 
Helpline
 
Helpline continues to receive a very high level of calls although good progress has been made in reducing the number of outstanding issues in the last few days. Extra staff have been drafted in and holidays cancelled but the call wait times and the response times for non urgent issues are longer than we would wish. It would really help if you did not call the helpline regarding issues notified in this bulletin and consider delaying calling regarding non urgent issues to allow helpline to reduce the backlog more effectively. We will, of course, endeavour to resolve all reported issues as quickly as possible.
 
QoF v12 Ruleset
 
The QoF v12 Ruleset will be distributed in DLM 271.
 

The daily generation of QoF Clinical Audit statistics, which was due to be implemented in DLM 270 will now not be available until DLM 271.

A problem has been identified in  DLM 265 where intermittently pathology results are not being filed into the patient record.  This error occurs when pathology results are being moved from GP Communicator into Mail Manager and when it occurs you will see an error message saying;

Codebase Error -69 has occurred duplicate instance found error opening file in P:\MAILMAN.DBF

You will then be asked to click OK this will then produce the error below

Failed to initialise database connections in DBLoad

When you have click OK to this message the message load will stop although it is not obvious that the messages have not passed to Mail Manager

The consequence of this error message will be that some pathology messages being delivered in this batch will not go into Mail Manager and hence will not be filed into the patient record.  However, they will show in GP Communicator as being passed to the Clinical System.

Where you have experienced this error message we recommend that you request your laboratory sends you paper copies of the results in this batch so that you can manually check the results are in the patient record.

We are currently working on a fix for this problem and will issue this shortly.  We are also working on a way of programmatically identifying and filing any historical results in GP Communicator that have not been filed into the patient record.

As soon as we have more information on this problem we will issue a further communication. The Helpline is currently experiencing a very high volume of calls due to this error and we would appreciate if you do not call regarding this issue until you receive further instructions from INPS. We apologise for the inconvenience that this may cause your practice.

The South East Wales Cardiac Network (SEWCN) have, with some technical help from INPS, produced a referral guideline and print out report in order for practices to ensure that they have the correct data for each patient who is being referred.

Click here to download the guideline and user guide

We have become aware of a problem when you import a Miquest response into CHART after editing.

Please note that we do not recommend the use of Microsoft Excel when viewing, cutting or pasting any Miquest or DES_Report results.  Excel can alter some data if it is deemed to be in the incorrect format and we have found that Excel can delete inverted commas when data is copied into it, which will render the CHART queries invalid. Instead, all copying, pasting and viewing of the documents should occur in either Notepad or in similar text editor software such as Textpad.

1. The patient's latest smoking status is a Current Smoker code and this has been recorded in the 15 months up to 1st April 2009 (27 months in Records 23).

2. The patient is over 25 and their latest smoking status is Never Smoked. This also has to be recorded AFTER the patient's earliest diagnosis for inclusion on the Smoking register (not needed for Records 23) and AFTER the patient's 25th birthday.

3. If the patient is 25 or under and their latest smoking status is recorded as Never Smoked and in the 12 months up to 1st April 2009.

4. The patient's latest smoking status is an Ex-Smoker record and is recorded  in the 15 months up to 1st April 2009 (12 months in Records 23).

5. The patient''s latest smoking status is an Ex-Smoker record and between 1 and 2 years prior to it they also have an Ex-Smoker record. Another record also needs to be recorded between 2 and 3 years prior to the latest Ex-Smoker code. There needs to be 3 consequetive codes, as such any Current Smoking code recorded after the earliest of the 3 Ex-Smoker codes breaks the chain.

In Records 23 patients under 15 are excluded.

Please see the business rules for the list of codes for Smoking Status, Current Smoker, Ex-Smoker and Never Smoked.

If you want to enable a user to be able to search for inactive patients in Consultation Manager (i.e. those who have transferred out), you can enable this for them in the Security module of Control Panel.

Firstly, open Control Panel and select the Security module.

In the right-hand pane, click on the + next to Global.

Right click on "Access to Archived patients", then click  "Add User(s) to Function", then select the user you want to grant access. (If you want to select more than one user, hold down the Control (Ctrl) key on the keyboard as you click them.

Click OK when done, and close out of Control Panel.

If you want to add a full group of users, rather than just one, you can use the "Add Group(s) to Function" option when you right-click on "Access to Archived Patients".