See new integrated solution available in 13.164 here

Background:

NHS Wales Risk assessment scores are applicable from 1st April 2018.

These scores are recorded at COT creation and sent through to the NHS in the normal XML file transmission process.

Requirements:

• EXACT v12.13 or later
• UK database with an active Wales NHS Payor
• Initially the scores will be optional but they may become mandatory in future.

Multiple optional entries added to the clinical dataset with effect from 1 April 2018:

• Risks from Medical, Social and Dental History, Tooth decay, Periodontal Health and Other Dental need RAG status and the number of teeth in the patients mouth.
• In addition the number of Decayed Permanent (9320) and Decayed Deciduous (9323) teeth are to be completed for Wales as well as England and isle of Man.

The new 9000 codes are purely based on the clinical judgement of the performer, with the exception of the total teeth in the mouth which is an actual count and should reflect the patient's oral status at the start of a course of treatment.

NHS-RISK service:

The scoring is based on a NHS·RISK service:

Configuration options:

Depending on a configuration checkbox, this service can be used in two ways:

• It can be manually added to a COT as required, in which case it can also be deleted from the COT, or
• A practice can configure it to be automatically added at COT creation, in which case it cannot be deleted from the COT and all risks must be assessed.
  This enables Practice Managers to compel the capture of risk assessment scores in order to better meet NHS requirements.

Characteristics:

• The service has a code NHS-RISK and a description Risk Assessment.
• No FP17/O Data is set
• Denplan Category is None
• DMF category is Other
• The service is listed in the chart tab Services list by default
• The service has an assigned graphic.

Procedur overview:

1. Chart the NHS·RISK service only if there are risks to assess
2. Tick as complete.
3. Enter the Risk assessment information in the Risk Assessment window.

To configure "Always Collect Patient Risk Assessment Scores" for the NHS Payor

Select File > Payors, and select NHS.

The screen includes a checkbox Always Collect Patient Risk Assessment Scores.

This is defaulted to un-ticked (OFF) in v12.13.

Always collect patient risk assessment scores

If this checkbox is ticked, the following applies with the Risk Assessment Service:

• It is mandatory per COT.
• It is automatically added to COTs as they are created.
• You must chart every risk in the assessment.
• You cannot delete it from the COT (a message will display: "The NHS-RISK service cannot be deleted from this Course of Treatment")

  

If this checkbox in un-ticked, the following applies with the Risk Assessment Service:

• It is optional, and has to be manually added to a COT.
• If you have added it manually, you must chart at least one risk.

Whether ticked or untciked the following applies:

• Only one NHS-RISK service can be added per COT. If you attempt to add a second you will see an error message:

  

To enter Risk Assessment Scores for NHS Treatment from the Chart

1. Add a COT for NHS.
2. The Risk Assessment may already be included in the COT, depending on the configuration setting.
   Otherwise, if there are risks to assess, chart the NHS-RISK service:

   

   
   

3. Double-click to open it:

   

   
   

   If the risk assessment is optional, and you have added it manually, you must chart at least one risk.

   (TIP: don't chart the service if there are no risks to assess)

   If the risk assessment is mandatory, and it has been added automatically to the COT, you must chart every risk.

   
   Risk factors can have these possible scores: Unset, Red, Amber, Green.

   (Red is included only with Periodontal Health, Tooth Decay, and Other dental needs).

   
   

   So long as a checkbox is not set, you can specify as many risk factors as required.

    

   
   

4. When complete, click OK.

   Possible prompts:

   For an incomplete optional risk assessment you need to confirm Yes that you wish to continue:

   

   For a mandatory risk assessment you will be reminded:

   

To edit the NHS-RISK service by Tooth History > Edit Chart Item > Edit Risk Assessment

Click the View Risk Assessment button:

To re-add the Welsh NHS.RISK service, in the case where it has been deleted

If this service has been accidentally deleted, users can add the service back by requesting Support Team help.

A Support Team member then reruns (upgrades) the Add Welsh NHS Risk service to re-add the service :