🧾 CLINICIAN | Asthma under 6 on repeat asthma medication - no diagnosis - review status

1. Supports AST_REG
   Children under the age of 6 who are (or will be) old enough to be included on the asthma register AST_REG. They have received asthma medication in the past 12 months, but do not have a coded diagnosis of asthma. Review patients to identify whether it is appropriate to diagnose asthma. 

🧾 CLINICIAN | COPD Newly added to register

• 
  

  Supports COPD_REG
  
  Patients who have been added to the COPD register for QOF v51, but they do not have a valid code for the previous register, but do have one or more codes from COPDDIAG_COD or COPDPROC_COD. Patients listed here are most likely going to have codes relating to COPD monitoring or invitations from the past 2 years, either used for other respiratory conditions such as bronchiectasis or accidentally used for recall. 
  

Use the output QOF 2026/27 - COPD to identify the affected codes and consider whether they need to be removed. All instances would need to be actioned to remove a patient from the register. 

🧾 CLINICIAN | COPD Removed from register

• Supports COPD_REG

  Patients who have been removed from the COPD register for QOF v51. They do have a code present in COPD_COD, but do not have any codes from COPDDIAG_COD or COPDPROC_COD. 
  

Use the output QOF 2026/27 - COPD to identify the affected codes and consider whether they need to be removed. All instances would need to be actioned to remove a patient from the register. 

🧾 CLINICIAN | Diabetes on alternative lipid-lowering therapy without statin PCA

Supports DM034, DM035
Patients are on a non-statin lipid-lowering drug (e.g. ezetimibe), but have no PCA code recorded to explain why a statin isn’t being prescribed.

• If a statin is declined, contraindicated, or not tolerated, add the appropriate PCA code to ensure QOF compliance.

🧾 CLINICIAN | Frailty Higher Rockwood than diagnosis - consider moderate/severe coding

Supports CD001/CD002/DM020/DM021/DM034/DM036/HYP010/HYP011.

Patients whose most recent frailty diagnosis was mild (or none), and the most recent Rockwood score or assessment was at least 6. It is in the Practice’s interest to action patients listed here as they can be removed from the target requirements. 

• Add a diagnosis code 'Moderate frailty' or 'Severe frailty' to remove patient from QOF indicator (or move from DM020 to DM021). 

🧾 CLINICIAN | Frailty Lower Rockwood than diagnosis - consider mild coding

Supports CD001/CD002/DM020/DM021/DM034/DM036/HYP010/HYP011.
Patients whose most recent frailty diagnosis was moderate or severe, but the most recent Rockwood score or assessment was less than 6. These patients would technically already be excluded from the affected indicators, but arguably the more recent Rockwood may suggest the patient is anything but frail. Use the report to review frailty and Rockwood coding, both in terms of dates and scores. Some frailty diagnoses may be many years ago while Rockwood is recent. 

• Add the diagnosis code 'Mild frailty' to reinstate patient to QOF indicator (or move from DM021 to DM020)

🧾 CLINICIAN | Heart Failure LVSD with ejection fraction recorded

Supports HF009.
Patients with heart failure and LVSD were previously included in the HF2 register. A preserved or mildly reduced ejection fraction has been recorded, or an ejection fraction percentage has been documented which may indicate HFrEF.  

Use the output QOF 2026-27 - Heart Failure to review coded ejection fractions, paying particular attention to ejection fraction percentages less than 40% which should be coded as a reduced ejection fraction. 

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🧾 CLINICIAN | Heart Failure LVSD without reduced ejection fraction

Supports HF009.
Patients with heart failure and LVSD were previously included in the HF2 register. No ejection fraction has been recorded (ie: they only have a code for LVSD). 

Use the output QOF 2026-27 - Heart Failure to identify the earliest diagnosis dates to locate documents referencing ejection fractions or echos.

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🧾 CLINICIAN | Heart Failure No LVSD or reduced ejection fraction

Supports HF009.
Patients with heart failure may not be correctly classified. Review diagnoses for evidence of LVSD or reduced ejection fractions. 

• Use the report QOF 2026-27 - Heart Failure to identify the earliest diagnosis dates to locate documents referencing ejection fractions or echos.
  

Use the output QOF 2026-27 - Heart Failure to identify the earliest diagnosis dates to locate documents referencing ejection fractions or echos.

🧾 CLINICIAN | NDH Gestational diabetes - added to register this year

Supports NDH_REG.
Patients with a history of gestational diabetes who were not on the NDH register last year, but have been added to the new expanded register. The purpose of this report is to demonstrate the additional number of patients on the register.

Use output QOF 2026/27 - Frailty or other reports in the Indicator Navigator folder to understand which of these patients may be surprised to be invited to a blood test having not had one for several years.