QRISK2 functionality has now been re-enabled in SystmOne and the following Notice Board messages have been published to users.
For GP units:
In April, TPP identified code mapping errors with the integrated QRISK2 Calculator, which is used to estimate 10 year cardiovascular risk in individuals. This was caused when the QRISK2 calculator on SystmOne was pre-populated with entries from the medical record, or when QRISK2 scores were used to identify patients through Clinical Reporting. As a result, scores given to patients in practices using SystmOne since 2009 may have been inaccurate. If clinicians have cleared the calculator and manually entered the patient data and medical history fields, the score will not have been affected by the code mapping error. These errors in code mapping do not affect use of QRISK2 when used online.
As a safety precaution, TPP requested that users stop using the QRISK2 Calculator so that TPP could carry out a thorough investigation. With assistance from HSCIC and MHRA, new code mappings have been created and the QRISK2 Calculator within SystmOne has been validated for use.
Following clinical advice from NHS England, TPP has designed clinical reports which identify four cohorts of patients who should be prioritised for clinical review. Newly calculated current risk scores will be higher in some patients and lower in others. Some of the increase or decrease may be due to the original code mapping error and some may be due to change in risk factors or change in treatment since the original score was calculated. Tests suggest that the average difference between the original and newly calculated current scores is relatively small. The main clinical risk for patients arises when the change in score has taken them above or below the threshold at which treatment is usually considered.
Follow-up: There are two documents for practices which can be accessed via the links below:
• NHS England Clinical Guidance QRISK2 Incident – This contains the NHS England National Clinical Directors’ recommendations regarding any patient reviews.
• TPP User Guide – This contains guidance to assist users with reviewing patients found within the cohorts.
For non-GP units:
The QRISK2 tool, which is used to estimate 10 year cardiovascular risk, has now been re-enabled and is available for use at your organisation.
TPP disabled the tool after identifying errors in the code mappings. With assistance from HSCIC and MHRA, new code mappings have been created and the QRISK2 Calculator within SystmOne has been validated for use.
As part of an operation co-ordinated by NHS England, GP practices have been provided with details of patients registered at their practice that may require a review. This means that the majority of patients with QRISK2 scores at your organisation will be dealt with by their registered GP, and you will not be required to take any action to review them.
However, for some non-GP organisations there will be a small number of patients whose records cannot be fully reviewed by their GP due to data sharing regulations. These patients will need to be reviewed by the organisation which recorded the QRISK2 score originally. Communications with instructions will be sent to organisations as soon as these patients have been identified.
A suggested template letter is found here NHS England Suggested Template Letter (1)