QOF FAQs 
 

Depression 
 

1. The current rule set for Depression 2 identifies the latest recording of the severity assessment. This means that if the severity assessment tool is used for ongoing monitoring of the condition then the initial assessment will not be identified and the practice will not obtain the points even if the initial assessment was performed within one month of diagnosis.

When drafting the business rules decisions have to be taken as to whether to use the first, earliest or latest instance of a defined Read Code in the patient record.  Additionally the severity assessment code needs to relate to the date of the Depression diagnosis.  
 

You are correct in stating that if practices use the assessment tool to monitor ongoing progress then this recording of the code will be identified rather than that related to the initial assessment. In these instances PCTs are reminded of their discretionary powers to vary both the numerator and the denominator. 
 

Your comments have been forwarded to the business rule team to consider if this issue can be addressed from a technical perspective. 
 

2. Can you confirm that Depression 2 relates to all newly diagnosed patients with Depression from 1^st April and not patients who are experiencing a recurrence of Depression?

The Depression diagnosis code cluster identified within the rule set searches for the latest first or new episode of the associated Read Code. Therefore if the episode ofDepression is recorded as a recurrence rather than a first or new episode then it should not be identified. 
 

3. Can you confirm that the patients being measured for Depression 1 and for Depression 2 are based on independent registers?

The denominator for Depression 2 includes all patients with a new diagnosis of Depression, excluding those with post-natal Depression. The denominator for Depression 1 includes those patients with a diagnosis of diabetes and/ or heart disease. 
 

Consequently, each indicator has a unique register associated with it

Depression 1: a register of patients with a diagnosis of diabetes and/or heart disease

Depression 2: a register of patients with a new diagnosis of Depression in the current QOF Year 
 
 

Mental health 
 

4. Mental health registers at our practices have risen dramatically. Having looked at the business rules I think this is due to instances of E112. Single major depressive episode. As the guidance refers specifically to schizophrenia, bipolar disorder and psychoses should this code be included?