Last review date 03/02/2023

The Diabetes template can be accessed through auto-consultation> ardens CONDITIONS DIABETES and ENDOCRINOLOGY, by selecting the orange 'd' icon in the demographics box or by searching in the bottom left-hand corner of SystmOne.  


Home 


The home page will give you access to the different pages of the template (diagnosis, review etc), as well as a summary of relevant medical history for the patient. Please see our Home Tab Support Article for more information.


Diagnosis


If the patient is presenting with possible symptoms of Diabetes you can access the template from the Auto consultations drop down > hover over Ardens CONDITIONS DIABETES AND ENDOCRINOLOGY > select the Diabetes option. The home page has an option on the left for diagnosis. This will guide you through recording relevant tests and criteria for diagnosis of Type 1 or Type 2 Diabetes. Links to the NDH and Gestational Diabetes templates can be found in the bottom right corner. 


Review and Care plan


If the patient is coming in for their Diabetes review you can access the template from under the patients demographic box using the orange 'd' icon. This will open the template up and select Review on the left or at the top of the template. Note - the review is split into two tabs for Assessment and Plan. 


You can work through the review accessing:

  • Scoring tools 
  • Relevant screening templates (foot, eye, memory etc)
  • Correct coding for contract requirements (QOF codes shown with the red star, local contracts with yellow stars)
  • Formularies and drug monitoring
  • Patient leaflets and care plans


The 9 Key Care processes are also labelled on the assessment page but can be accessed separately on the Key Care tab. 


Remember that the care plan will only auto-populate with the information you have just entered if you click 'OK' to the template first - then re-open to click on the care plan option which will open in Word. 



Hypos & Hypers 


Page 5 at the top of the template has relevant information for recording hypoglycaemic and hyperglycaemic events. This includes relevant patient information and driving advice links. 



Remission


The Remission tab sets out the relevant criteria based on results, weight and medication for a patient to be in remission. The remission code still requires patients to be reviewed on an annual basis and will still include the patient on the QOF register. The diabetes resolved code shown at the bottom of the template will remove the patient from the register if required.



There are further pages for general Notes, Education, and Resources, which includes Referral options. 


Reports


You can find some useful Diabetes reports by going to Clinical Reporting > Ardens > Conditions I Diabetes


These reports are split into sub folders:


Activity Last Month


These reports will show you any new diagnosis, reviews and screenings done in the last month at your practice for the relevant conditions listed. (These reports look at last month, from the 1st to the last date of the month e.g. If you ran these reports in June, they would show data from the 1st May to the 31st May).


Alerts


This folder identifies potential patient safety issues which clinicians may wish to address, such as "?DM1 or DM2 - Both codes recorded - review and mark in error incorrect code" which will identify patients where both Type 1 and Type 2 Diabetes codes have been added to their notes - these should be reviewed and one of the codes marked in error if applicable to ensure the correct diagnosis is recorded.


Case Finders


The Case Finders folder identities patients who are may not be correctly coded. Practices are advised to review the list of patients and add the correct disease code to ensure the patient is subsequently reviewed and managed correctly. 


Data Quality


This folder contains a couple of searches where patients may have been coded with inappropriate codes and can be reviewed and recoded as necessary.


LCD I T2DR I Activity in last year


This folder will help practices identify the activity of patients with Type 2 Diabetes who are eligible for referral to the NHS Type 2 Diabetes Path to Remission Programme. You will be able to see various activity such as those that have been coded as commenced, completed or declined from this programme in the last year.


LCD I T2DR I For review I Referral


This folder will help practices identify patients with Type 2 Diabetes who may be eligible for referral to the NHS Type 2 Diabetes Path to Remission Programme. These patients’ records must be clinically checked before referring to ensure that referral is appropriate.


NDPP I Activity in last year


Type 2 diabetes can usually be prevented and the NHS are piloting the National Diabetes Prevention programme (NDPP) which aims to identify those at high risk and refers them onto a behavior change programme.


The NHS DPP is a joint commitment from NHS England, Public Health England and Diabetes UK (NDPP).


The first folder includes searches that measure the latest NDPP status in the last 12 months, including patients who have had an NDPP completed, DNA or excepted in the last year.


NDPP I For review I Referral


This folder identifies patients that meet the criteria for a referral to NDPP, but have not yet had one so these patients can be reviewed and referred as necessary. The second search will identify patients that potentially could be eligible for an NDPP referral but have a code in their notes of having a history of eating disorders. Again any patients in this search can be reviewed and acted on appropriately.


Performance Indicators


This folder can be used to track where certain elements of care has not been completed, for example diabetic patients who have not had foot screening or other tests recorded in the last 13m.  Practices can see a breakdown of this information by Type 1 and Type 2 diabetes, gestational diabetes, and prediabetes.  


We have used a 13 month timeframe for these searches as many guidelines and contracts are for activities to be done annually or within a financial year.  If we kept our searches to 12months it does not allow for much leeway for those patients unable to attend exactly on their annual recall date and as these searches are performance indicators and not for contractual payment we felt this timeframe would give a true representation of how the practice is performing. 


Registers


This folder contains detailed registers for your Diabetic patients that goes above and beyond the standard QOF Registers.


Weight management ES eligibility


The Weight management ES eligibility folder identifies patients with either Diabetes or Hypertension eligible for referral under the weight management enhanced service. Due to their conditions, they qualify for referral through the NHS Digital Weight Management Programme.



Please see the below video as a walkthrough of the template and key features.