Working with PRIMIS, Sharon Gray, Leanne Hurren and Nick Bennett* from Huntingdonshire PCT, identified anticoagulation monitoring and near-patient testing as key areas of concern.

Initially, practices were providing figures for patients whose blood tests were done at the local hospital. Practices then began to express difficulty in extracting and identifying those patients who had received a blood test in a practice. A system was needed to differentiate between these two groups.

As 87% of Huntingdonshire practices use EMIS clinical systems, this is where the team concentrated their efforts. Working with Lorraine Baker, the audit clerk from one particular practice, the team devised a simple template that practices could use when taking blood, to ensure more accurate recording.

Following the project, practices that made full use of the template and had coded correctly were able simply to search on the monitoring codes (66P and 66Q) to get their full results.

Practices not fully utilising the template, or not coding correctly, also had to search on the relevant prescribed medication. After this fuller search, they then had to check patient data by hand, to see whether blood had been taken at the surgery but had not been recorded.

After completing the search and exporting the results to Microsoft Excel, the report displays the data as one line per patient. Patients that can be included in the quarterly enhanced services figures will have their monitoring code and 'blood taken' code showing the same date. If accurately recorded, those patients who had blood taken at a hospital will be highlighted in yellow, clearly displaying that they cannot be included in the return. All practices involved used a copy of a spreadsheet template supplied by the Huntingdonshire team, so the chance of an error in data entry at the PCT was minimised.

As of August 2005, 80% of practices in Huntingdonshire PCT are now using this new template.

This project was entered as a poster at the PRIMIS Conference 2005.

* Since this case study was first produced, Huntingdonshire PCT was amalgamated into Cambridgeshire PCT, following the 2006 PCT restructuring.

** Neither Sharon, Leanne or Nick now work as facilitators.