These searches support opportunistic and end-of-year QOF work across both obesity indicators. These searches are ideal for systematically reviewing patients throughout the year and especially in QOF year-end clean-up.

An output QOF 2026/27 - Obesity is offered to help stratify patients for actioning, in particular OB005.

🧾 NOT ACHIEVED | Target now for referral to weight management (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. 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. 

🧾 ACTION | Latest BMI at least 30 but not recorded this year

Patients whose most recent BMI is at least 30 (or at least 27.5 if BAME), but it has not been recorded during the current contract year. Targeting these patients for an updated BMI reading may make them eligible for OB004, and potentially OB005. 

• Action: Contact or invite patient to obtain an up to date weight, then calculate BMI.

These searches are related. NOT ACHIEVED is for patients with a BMI recorded this year, while ACTION requires a BMI to be recorded which, if greater than 30, should immediately trigger the offer of a referral to weight management.

🧾 ACTION | Started tirzepatide in last 12 months but no obesity pathway code

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.

🧾 NOT ACHIEVED | Target now for obesity pharmacotherapy (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. 

🧾 ACTION | Target for obesity pharmacotherapy after updated BMI

The output QOF 2026/27 - Obesity is configured to display the latest values. This means that it is possible for patients in the NOT ACHIEVED | Target now... report to appear whose latest BMI is less than 35 (or 32.5 if BAME background). Such patients have had a BMI above threshold during the year - making them eligible for OB005 - but have subsequently lost weight. They remain eligible for the remainder of the year, and may be an "easy win" to help achieve OB005.

🧾 REVIEW | Patient with BMI >=35 has 3 long term conditions AND risk factor for dyslipidaemia

Patient has 3 conditions of ASCVD, hypertension, type 2 diabetes, obstructive sleep apnoea, but most recent blood results suggestive of dyslipidaemia not during the contract year.  

Use the report to review latest values, and any lapsed courses of lipid lowering therapy. Repeating BMI and bloods may add patient to OBES2_REG. 

Issuing 1 course of lipid therapy in the second half of the contract year may be sufficient to make the patient eligible for OB005. 

🧾 REVIEW | Patient with BMI >=35 has 3 long term conditions AND risk factor for raised BP

Patient has 3 conditions of ASCVD, type 2 diabetes, obstructive sleep apnoea, dyslipidaemia, and most recent blood pressure is suggestive of hypertension. 

Use the report to review latest values then target patients. Repeating BMI and BP followed by a new diagnosis of hypertension may add patient to OBES2_REG. 

🧾 REVIEW | Patient with BMI >=35 has 3 long term conditions AND risk factor for raised HbA1c

Patient has 3 conditions of ASCVD, hypertension, obstructive sleep apnoea, dyslipidaemia, and most recent HbA1c is suggestive of type 2 diabetes.  

Use the report to review latest values then target patients. Repeating BMI and HbA1c followed by a diagnosis of type 2 diabetes may add patient to OBES2_REG.