025B PCN DES
Primary Care IT has again produced a comprehensive set of searches to support the PCN DES 2026/27 requirements.
These are based on and built according to the business rules originally published by NHS Digital on 30th April 2026 and referencing the Network Contract Directed Enhanced Service guidance.
The current version of 025B PCN DES is v3.6
PCN DES searches
The PCIT PCN DES searches can be found in the following folders:
Cancer
This contains a number of areas that will ensure optimal performance for the early cancer diagnosis element of the PCN DES:
Cancer Screening Programmes
Searches to support with Cancer Screening Programmes and improving uptake can be found in folder 028.
Suspected cancer referrals - Outcomes audit
This folder will help you to audit your previous suspected cancer referrals and see how many of them have been diagnosed with cancer subsequently. It also allows you to see cancer diagnoses that have not been preceded by a 2 week wait referral.
Suspected cancer referrals - FIT testing audit
This folder of searches is designed to work in conjunction with the PCIT suspected cancer diagnosis templates for colorectal cancer as well as HP290. These tools ensure that practices have a clear way of following up on FIT test requests prior to any suspected cancer diagnosis referral being made. Please note there is both a rolling version and a year end version of the 'Enrolled on colorectal cancer pathway without outcome' reports.
Suspected cancer referrals - Follow ups
This folder supports with safety netting of suspected cancer referrals and also allows you to audit suspected cancer referrals made during the last 12 months to check whether they have been reviewed in the suspected cancer clinic. This requires some coding compliance, utilising the following codes:
Seen in fast track suspected cancer clinic | 382761000000101 |
Fast track appointment cancelled by doctor | 2002091000006100 |
Fast track appointment cancelled by hospital | 2001691000006101 |
Fast track appointment cancelled by patient | 2001681000006104 |
Choose and book referral rejected by service provider | 511471000000105 |
Reason for referral delay | 397604009 |
Did not attend fast track suspected cancer clinic | 774581000000102 |
These codes would be used by any member of staff, primarily secretaries and coders, and then they can be cleared from the searches when a clinician has reviewed the patient and is satisfied the case can be closed. The code to use is Care complete [915811000006103]
Suspected cancer referrals - Referral audit
This folder allows you to count all suspected cancer referrals in the current contract year by referral type. An aggregate report is provided to view the number of each referral type by month.
Cardiovascular Risk
This contains a number of areas that will ensure optimal performance for the cardiovascular disease specification of the PCN DES:
AF
These reports are copied from 007 Prevalence Improvement. They have been designed to identify patients not currently diagnosed with AF who have particular codes on their record which may warrant further investigations to confirm or exclude AF as a diagnosis.
In some cases, the patient may be flagged due to the presence or absence of codes, for example patients on warfarin who have not had their valve replacement coded. Patients with resolved AF may be picked up by PI-AF04.
Cholesterol
The following reports allow you to look at patients who have had tests that would allow an opportunistic CVD risk assessment, as well as patients who have an already high risk assessment who aren't on a statin:
There is no way to remove patients with QRISK >10% from the statin report.
Heart Failure
Another set of reports copied from 007 Prevalence Improvement.
PI-HF01 identifies patients with hypertension and a coded ECG showing left ventricular failure, plus patients with AF who are on digoxin, none of whom are coded with Heart Failure.
Hypercholesterolaemia
One report allows you to look at patients who are at risk of familiar hypercholesterolaemia:
Hypertension
The following PCIT reports allow practices to identify patients who are likely to have hypertension:
These reports will show the 3 most recent blood pressures plus any medication courses used to manage blood pressure.
Care Homes
Simply a list of all patients coded as living in a care home, based on the PCN DES rule for recording patients in care homes. For each patient the report details their address, whether the Residential Institute code has been added, and what the most recent frailty code is.
Health Inequalities
The reports based on Core20Plus5 look for combinations of patients with the following characteristics:
Core 20 | Patients with a Townsend Score >2.5. Townsend Score is related to the Index of Multiple Deprivation. A score >2.5 indicates that the patient is in the 1st quintile (living in the 20% most deprived areas/postcodes in the country). Practices in affluent areas may have very low numbers of patients in the quintile, while other Practices may pick up a significant portion of their registered population. |
Cancer diagnosis | Patients with a coded diagnosis of cancer in the last 12 months |
COPD | Patients living with COPD |
Pregnant | Pregnant women who also appear in the Core 20 cohort plus any pregnant woman from a BAME community (regardless of their IMD/Townsend Score) |
Hypertension | Patients with raised blood pressure without a diagnosis of hypertension |
SMI | Patients with a Severe Mental Illness |
The number of patients in the Core 20 search will determine how many patients are picked up in the combination searches for patients with 1 or more additional characteristics.
Although Learning Disability is a key element of Health Inequalities, Learning Disability patients and searches around annual health check can be found in folder 025A due to the IIF requirement.
Heart Failure
There is a drive to categorise patient's heart failure beyond a simple 'Heart failure' diagnosis. Searches group patients on the register into those who have and have not had this aspect of the diagnosis coded. A report also draws out those categorisation codes which may be sorted in Excel to review how up to date the categorisation is.
| Heart failure with normal ejection fraction | 446221000 |
| Heart failure with mid range ejection fraction | 788950000 |
Heart failure with reduced ejection fraction | 70327007 |
Heart failure with reduced ejection fraction due to cardiomyopathy | 703275009 |
Heart failure with reduced ejection fraction due to coronary artery disease | 703273002 |
Heart failure with reduced ejection fraction due to heart valve disease | 703276005 |
Heart failure with reduced ejection fraction due to myocarditis | 703274008 |
Some patients with heart failure have an uncoded LVSD finding. This has an impact on QOF as there are indicators specifically for patients with HF + LVSD, in addition to the prevalence of the condition. Whilst we have not provided a report here to check all patients with a current diagnosis of heart failure, a report will show any patients with LVSD coded in the absence of a heart failure diagnosis as these patients would not even be on the Heart Failure register.
With the changes to Heart Failure registers in QOF for 2026/27, additional searches to support with Heart Failure and LVSD can now be found in 004B Routine QOF - *Indicator Navigator - Heart Failure
Proactive Care
Aggregate reports counting the number of coded Provision of proactive Care episodes during the year, and those whose proactive care ended.
| Provision of proactive care | 934231000000106 |
| Proactive care ended | 934691000000105 |
SMR (Structured Medication Reviews)
This contains a number of areas that will ensure optimal performance for the Structured Medication Reviews specification of the PCN DES:
You can see your performance for Structured Medication Reviews. You can also see patients who are at highest risk and therefore should be prioritised for SMR.
Target groups
This folder shows you different groups of patients you may wish to target for SMRs:
The first 4 groups (A-D) were transferred from the IIF part of the PCN DES at the end of the 2022-23 contract year, so the naming has been retained. SMR01E has been built according to PCIT's best interpretation of polypharmacy. This deliberately excludes appliances and nutritional supplements which are not strictly medications and would inflate the total number of active 'lines' on the medication screen, particularly if they exist more than once on a record..
Work to do
Social Prescribing
Aggregate reports counting the number of social prescribing referrals made during the contract year broken down by month, and counting the number of patients who declined social prescriber intervention (who did not also have a referral made) during the contract year.
| Referral to social prescribing service | 871731000000106 |
| Social prescribing declined | 871711000000103 |