This folder helps practices identify patients for opportunistic or end-of-year QOF work related to CHOL003 (statin treatment in high-risk patients) and CHOL004 (cholesterol control in treated patients). The searches support proactive intervention, coding reviews, and appropriate use of Personalised Care Adjustments (PCAs).
Patients eligible for CHOL003 who have had one invitation to discuss or initiate lipid lowering therapy. A second invitation is required before exception reporting for non-response.
Patients who have had two invitations and remain not on a statin. These are now eligible for exception coding under CHOL003.
Patients eligible for CHOL004 who have received one invitation for a cholesterol blood test. Sending a second invite allows for exception reporting if the patient does not engage. If the patient has had a raised cholesterol result recorded this year, there must be at least two invitations after the most recent result.
Patients with two invitations recorded but no cholesterol result. These can now be exception-coded under CHOL004.
Patients with LDL cholesterol above 2.0 this year. These cases may benefit from repeat testing, statin initiation, or review of current therapy.
A subset of the above report, patients with LDL or nHDL results close to the target threshold (LDL 2.0 - 3.0 or nHDL 2.6 - 3.6). Worth reviewing or rechecking as treatment may be required depending on updated readings.
Patients not on statin therapy and no PCA codes recorded. Useful group to target for either initiating statins or applying a valid exception code.
Patients not on therapy, no result recorded this year, but with a previously raised cholesterol result. High-priority for testing, intervention, or coding action.
Patients on lipid lowering therapy, no result recorded this year, and previously had raised cholesterol. Should be followed up to confirm control and support CHOL004 achievement.
Patients aged 80+, not on statin therapy, and only eligible for CHOL003 due to CKD. May be appropriate to apply a PCA based on age or clinical judgement.
Patients not on statins or alternative lipid lowering therapy, who have had a PCA previously. Review to confirm whether the exception still applies, or if statin therapy should now be considered.
Patients over the age of 80 who are showing as eligible for CHOL003 solely due to CKD. Clinicians may wish to review this cohort of patients to see if they do want to consider prescribing statins, or if this is not required.
Patients are showing as eligible for CHOL003 solely due to CKD, but have a normal eGFR. These are likely to be inappropriately coded.
Action: Recode CKD classification based on current renal function. If CKD is no longer clinically appropriate, correcting the code may remove the patient from CHOL003, avoiding unnecessary follow-up
Patients who are not on any lipid lowering therapy, with a statin PCA such as 'Statin declined' recorded this year. This is insufficient to remove them from the CHOL003 indicator.
Action: Add a lipid lowering therapy PCA such as 'Lipid lowering therapy declined'.
Patients on statin therapy, no lipid result this year, but previous result was normal. These are ideal for opportunistic testing โ likely to meet CHOL004 with one up-to-date result.
Patients not on a statin, no lipid result this year, but previous results were in range. May still be low-risk. A repeat lipid test could confirm if statin treatment or PCA is appropriate.