There is a process of configuration within a practice’s clinical system that must be in place, and patients must be assigned a specific code (V0) that ensures a practice is remunerated at a higher value level than the normal weighted capitation payment. Patients who reside in a residential institute (RI) attract a factor of 1.43 to the global sum payment, which is an uplift of 43% due to the increase in associated workload.
Adding an RI code to a patient record is the responsibility of the practice. The disparity between the number of patients residing in a care home and the payment received by the practice, has become more visible with the detailed PCSE statements, than with the previous Open Exeter ones. Although we do not yet have a sense of how widespread the issue is.
We are discussing this issue with PCSE and the five London ICBs and will provide further updates in due course. In the meantime, to ensure that your coding is correct for payments, please see the below links to relevant guidance which should enable you to check your coding and your clinical system configuration:
- PCSE Registrations Guidance, see page 9.
- Configuring Residential Institute codes in EMIS Web, for EMIS system configuration.
- The impact of nursing home registration and how to solve the problem – Primary Care IT, for EMIS coding.
- TPP SystmOne: Frailty Data Harmonisation Search Guide, for SystmOne system configuration and coding.
- Residential Institute Codes and Read Codes, for SystmOne.