NHS Risk Assessment - ACORN

NHS Wales practices are required to complete an ACORN (Assessment of Clinical Oral Risk and Needs) form for all standard Courses of Treatment (COT).

This guide is to support the detailed guidance issued by Welsh Government on the 22^nd May 2020.

The NHS Wales Payor has a revised tick box on Payor File: “Auto chart NHS Risk Service on COT creation”. It is on by default and will automatically add “NHS Risk Assessment” service to planned UDA COTs if a patient has not been assessed by the same provider in the previous 12 months.

An NHS Risk Assessment will NOT be automatically added to a NHS UOA (orthodontic) COT:

In order to fill out the ACORN questionnaire you will need to double click the service icon or ticking the NHS Risk Assessment Service. There are four tabs as shown below:

Ticking' Urgent Care' will alter the form questions to represent the urgent assessment as requested by the NHS. Equally, ticking ‘Patient is endentulous’ or ‘Patient is under 12’ will alter the questions that need to be answered on the form dynamically.

Relevant History

The three ‘Yes, No or Unset' buttons will send ‘Amber’ or ‘Green’ status in the claim XML.

Behaviours and Protective Factors

EXACT will default the high sugar and tobacco questions if these have been previously answered by the patient in their medical history. See full details in the Medical History section of this document below.

Clinical Findings

If all the questions leading up to an overall score have been answered, EXACT will attempt to default the overall score if it can. This will only happen the first time the form is filled in for the patient, and can be overridden at any stage.

Perio Health

The patient’s most recent BPE will be pre-populated on the form, so please ensure a BPE is completed before completing the assessment. These scores can be altered if necessary.

Ticking either the box for 'Patient is edentulous' or 'Patient unable to tolerate periodontal examiniation' will grey out the Perio Health tab as this data is not required. This was introduced in December 2021.

Edit Chart Service Item

If you need to access the edit screen again you can access ‘Edit Risk Assessment’ button from Edit Chart Item screen shown below:

Or - from Tooth History on Uncharged Treatment EG: