The reports in this folder are designed to be run and reviewed on a monthly basis to help practices stay on top of time-sensitive QOF indicators.

The searches have been built to look at the contract year (1st April to 31st March), so it is recommended to run the search WITHOUT a relative run date.

📋 ADMIN | AF needs CHA2DS2-VASc

Supports AF006
This report lists patients with atrial fibrillation who do not yet have a CHA2DS2-VASc score coded.

• It displays the AF diagnosis date and any previously coded scores.

• You can use the HP212 protocol (included in your subscription) to bulk-add CHA2DS2-VASc scores for these patients.

📅 Tip: Run this monthly, as newly diagnosed AF patients will continue to appear.

✨ View the HP212 protocol support article

📋 ADMIN | Recent diabetes but not referred to structured education

Supports DM014
Patients with a recent diabetes diagnosis but no code for referral to structured education.

• The referral must be coded within 9 months of diagnosis.

• The report shows the diagnosis date for easy review and timely coding.
  

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📋 CLINICIAN | Started tirzepatide in last 12 months but no obesity pathway code

Supports OB005
Patients with a BMI of at least 35 recorded this year who started tirzepatide during the last 12 months. It is essential to add code 'NHS obesity medication pathway started' [2386231000000101] dated within the current contract year for patient to be eligible for OB005. These patients are currently excluded from the OB005 denominator after rule 2.

• Review patient records to understand when and where tirzepatide was initiated. If recent (ie: within a few months of the start of the contract year) think about whether adding code is justified.

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📋 CLINICIAN | Target now for obesity pharmacotherapy

Supports OB005
Patients with a BMI of at least 35 (or 32.5 for BAME) recorded during the contract year, as well as 4 qualifying conditions who do NOT have a recorded shared decision-making discussion about the management of obesity and have NOT been offered NICE approved medicines management (pharmacotherapy) for use in a primary care setting with accompanying referral to suitable behavioural support programme. 

• Use the report to understand which conditions have caused the patient to be included. Some understanding of the qualifying criteria may be necessary, especially for ‘dyslipidaemia’.  
  

Consider separating patients into those who are already taking medication for obesity (ie: they only need referral to a behavioural support programme), and those not on medication who first need to be offered therapy. 

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📋 CLINICIAN | Target now for referral to weight management

Supports OB004
Patients with a BMI greater than or equal to 30 recorded in the contract year (or a BMI greater than or equal to 27.5 for patients with a BAME background), who have NOT been referred to a weight management programme within 90 days of the BMI being recorded. To maximise patient opportunities, patients coded with at least 2 invitations for obesity are included.

1. Use the report to identify recent BMIs. The user who coded the BMI is included to assist in identifying patterns were individuals may have forgotten to offer a referral. 

📋 CLINICIAN | Cholesterol on alternative lipid-lowering therapy without statin PCA

Supports CHOL003/004
Patients on alternative lipid-lowering therapy without a statin PCA code.

• If a statin is not indicated, declined, contraindicated, or not tolerated, apply the appropriate PCA.
  

📋 CLINICIAN | Recent heart failure diagnosis but not yet referred for echo

Supports HF008
Identifies patients with a recent heart failure diagnosis who have not had an echocardiogram or specialist assessment coded.

• Referral/assessment must be coded within 3 months before or 3 months after diagnosis.

• New patients are not treated differently.

• PCA codes (e.g. declined) can be used if appropriate to remove patients from the indicator.

🔍 CV | BP last month not to target NO previous PCAs no new antihypertensives

Patients with raised BP readings in the last month who:

• Have no new antihypertensive medication started

• Have no PCA code recorded within the last 3 years

Use this search to prioritise patients for treatment review or PCA coding.

🔍 CV | BP last month not to target NO previous PCAs BP 160/100 to 180/110

Subset of patients from the above search with BP readings between 160/100 and 180/110.

• Consider escalation of treatment or PCA application.

🔍 CV | BP last month not to target NO previous PCAs BP >180/110

Identifies patients with very high BP in the past month and no treatment change or PCA recorded.

• Ideal for urgent review.

🔍 CV | BP last month not to target NO previous PCAs BP <160/100 no change

Highlights patients with moderately raised BP, no PCA, and no change in management.

• These may have been overlooked.

📋 CV | Cholesterol LDL last month >2.0

Supports CHOL004

• Review statin prescribing or PCA suitability.

📋 CV | Cholesterol LDL last month borderline

Supports CHOL004

• May be suitable for statin optimisation or PCA application.

📋 HCA | Cholesterol no HbA1c this year

Supports CHOL004
Diabetic patients with no LDL or nHDL cholesterol recorded in the current QOF year.

• A simple blood test can secure QOF compliance.

📋 HCA | NDH no HbA1c this year

Supports NDH003
Patients with non-diabetic hyperglycaemia who have not had an HbA1c or fasting glucose recorded this year.

• Prioritise these patients for annual blood test recall.
  

🔍 Tip: Use EMIS Text Search

If you suspect that a clinical action was completed but not coded, use EMIS’s Text Search feature:

• Open the consultation page

• Click the ‘Text search’ icon in the EMIS ribbon

• Search for relevant terms (e.g. "declined", "referred", "reviewed")

This can help uncover missed coding opportunities and support accurate QOF reporting.