PCN - IIF ProjectProject Setup Practice Name National Practice Code Programme Activation 1. Please confirm which IIF targets you would like to activate: a. CVD-01 - Elevated BP reading with follow-up arranged b. CVD-03 - Statin optimisation in patients aged 25-84 with QRISK >20 c. CVD-04 - Referral for assessment for FH (familial hypercholesterolaemia) d. CVD-05 - Anticoagulation in AF e. SMR-01A – Medication errors f. SMR-01B – Severe frailty g. SMR-03 - Optimising DOACs (monitoring & dose check) h. RESP-01 – ICS optimisation in asthma i. ES-01 – Non-salbutamol MDI optimisations j. ES-02 – SABA carbon optimisation Step 1: Contacting Patients 2. Does your practice have any current ARRS professionals interested in contacting patients? Yes No If yes, please specify their roles below 3. Are you happy for patients within the activated cohorts to be contacted by the Putting Patients First team (NB: this may involve SMS texts or phone calls)? Yes No Step 2: Reviewing patients 4. Are you happy for patients to be reviewed by Putting Patients First (PPF) healthcare professionals? Yes No 5. Are you happy for contact to be made to your practice using EMIS tasks (for this, a new task group can be set up specifically for messages from PPF to your practice) in order to pass appropriate suggestions regarding: a. Further physiological measurements that might be required e.g. repeat blood pressure Yes No b. Repeat tests including blood tests that would be due Yes No c. Medication changes (e.g. anticoagulation dose change) Yes No 6. Are you happy for PPF GPs to be perform medication changes (e.g. initiation of statins), where appropriate? Your practice will be informed of any medication changes made. Yes No 7. Where inhaler optimisations are advised, are you happy for patients to be offered the Easyhaler range of inhalers, as the preferred combination of cost-effective and carbon neutral inhalers? Yes No Step 3: Feedback> 8. Are you happy for patients to receive a feedback questionnaire for evaluation of the programme? Yes No Key Contact - Admin Lead from your Practice: Please note that this will be for setting up the EMIS task group and receiving IIF update reports, not for tasking clinical actions. First Name Last Name Email Key Contact - Clinical Lead from your Practice: First Name Last Name Email Thank you!