The tool was originally developed in 2002 to cover Diabetes and CHD NSF criteria but has grown to encompass the nGMS Contract, influenza and Pneumococcal campaigns, etc.

Data Quality support in Gloucestershire is provided to the three local PCTs as part of a shared service under the umbrella of the local Primary and Community Care Audit Group. PRIMIS+ facilitators in each PCT support practices to improve the quality of their coding and Chronic Disease Registers, check and update templates, perform audits, explain data quality issues relating to the Quality and Outcomes Framework and the Quality Management and Analysis System (QMAS), and extract data for wider use by organisations such as the Health Protection Agency.

In addition, the PRIMIS+ facilitators design individual tools for countywide audits on specific areas. Having set up tools to extract data for stroke secondary prevention, heart failure, coronary heart disease and diabetes, facilitators are now looking beyond the requirements of the nGMS Contract to provide a new falls and osteoporosis extraction tool.

Falls and osteoporosis has been chosen as an area in which better data quality could significantly improve care for patients. Osteoporotic fractures are associated with significant morbidity and mortality. They cost the NHS nearly £2 billion a year and account for more hospital bed days than ischaemic heart disease, diabetes, chronic airways disease or heart failure. There is good evidence for the effectiveness of some interventions in reducing the incidence of fragility fractures. Working with the Osteoporosis and Falls Programme in the University of Derby's Department of Radiography and Health Informatics, the Audit Group in Gloucestershire will examine the levels of identification of at risk patients and whether appropriate interventions are being delivered. The criteria associated with falls and osteoporosis will be derived from clinical guidance from NICE, the Royal College of Physicians and the National Service Framework for Older People.

One of the initial aims of the audit is to improve the quality of the data collected about falls and osteoporosis. Some patients receive advice or treatment about falls or osteoporosis but do not receive a diagnosis. Some patients are diagnosed but do not receive treatment or risk assessment. PRIMIS+ facilitators are supporting practices to make better data quality in this area a priority, in order to significantly reduce morbidity and mortality of patients at risk from falls and fractures and to assist PCTs implement NICE Technology assessment and guidelines.

You can access the website of Gloucestershire Primary and Community Audit Group here.