Referrals to IMOS/IOSS
NHS England & NHS Improvement have received a number of enquiries about patient charges for an IMOS/IOSS referral during this current period. We have therefore liaised with our Senior Clinical Advisor to update you on the most appropriate way to make such a referral.
As you are aware, you must undertake a full examination to claim a banded course of treatment (COT). For many practices, the majority of current patients’ treatments are within urgent COT’s as they do not have the capacity to help patients with urgent needs and also see patients for routine care. However, for patients who require referral for treatment it is clearly better that they have a full examination to identify all treatment needs so that any referral can ensure that all treatment requiring referral is included. This requires a banded COT to be commenced, as the most appropriate way to deal with the patient’s clinical needs.
If you examine a patient and determine they require a referral to IMOS/IOSS, you should undertake the full examination and charge the patient the band 2 COT. You claim the band for the treatment you are going to undertake so if the patient does not have any other treatment identified at the full examination, the patient would still pay a band 2 charge (because you are referring them to IMOS/IOSS which is an extraction and therefore a band 2 charge) and your submitted activity would be a band 1 COT. IF, the patient requires a number of fillings or other treatment which fits within a band 2 COT, you would submit your activity as a band 2. The band 2 COT should remain open until you are able to complete all of the treatment identified under that COT – this does not mean that you must provide this treatment straight away. It would be for you to make a clinical decision as to the urgency of that treatment and plan this into your workload along with the discussion with the patient. The COT’s will remain open for some time; however, you have 2 months from the date of COMPLETION of the COT to submit it to the BSA, so you are within the regulations for submitting activity data. This minor change will not make you an outlier in any data submissions monitored by the BSA as the expectation is for services to return to some normality as we work through and adapt to the restrictions on the service provision.
So, to reiterate, IMOS/IOSS referrals should return to the ‘usual way’ – a banded COT must be undertaken, and the patient will be charged for the band 2 (you tick the box ‘on referral’ on the FP17) – you claim the banded COT for the treatment you carried out or have identified as requiring to be carried out (even if planned and not undertaken at that point). Close the COT if you have completed all of the work and submit it to the BSA or leave the COT open until you complete all the treatment identified at the examination.
See also
https://nhsbsa-live.
COVID-19 Triage Forms: From 1st December 2020, NHS BSA have made changes to the COVID-19 triage forms process and revised guidance can be found here: https://www.nhsbsa.nhs.uk/
