Overview

Annex C introduces new QOF indicators focused on Cardiovascular Disease (CVD) prevention, aligning with NHS England’s priority to improve early detection and management of cardiovascular risk factors. These indicators are designed to enhance proactive patient care and reduce the long-term burden of CVD on the healthcare system.

Key Changes to QOF for CVD Prevention

1. Amendments to the QOF indicators targeting high-risk cardiovascular patients.
   
2. Adjusted achievement thresholds to incentivise action.
   
3. Redistribution of £198m from retired QOF indicators into CVD prevention funding.
   
4. Increased focus on lipid management, and blood pressure in hypertension, STIA, CHD and diabetes.
   

Action Points:

1. Review the new CVD QOF indicators.
   
2. Update practice workflows to improve proactive patient management.
   
3. Ensure clinical teams are trained on updated indicators and intervention approaches.
   
4. Monitor performance to ensure achieving the more challenging targets
   

New CVD Prevention Indicators & QOF Points Allocation

2025/26 QOF Indicators for CVD Prevention:

Blood Pressure Management

1. Hypertension
   

1. HYP008: Percentage of patients aged 79 years or under with hypertension in whom the last BP reading is ≤140/90 mmHg.
   
1. Threshold Change: 40%-77% (2024/25) → 40%-85% (2025/26
   
2. QOF Points Change: 14 → 38
   

1. HYP009: Percentage of patients aged 80+ with hypertension in whom the last BP reading is ≤150/90 mmHg.
   
1. Threshold Change: 40%-80% (2024/25) → 40%-85% (2025/26)
   
2. QOF Points Change: 5 → 14
   

1.  Stroke
   

1. STIA014: Percentage of stroke/TIA patients aged ≤79 with BP ≤140/90 mmHg.
   
1. Threshold Change: 40%-73% (2024/25) → 40%-90% (2025/26)
   
2. QOF Points Change: 3 → 8
   

1.  Lipid Management & Statin Therapy

1. CHOL003: Percentage of CHD, PAD, Stroke/TIA, or CKD patients prescribed a statin.
   
1. Threshold Change: Maintained at 70%-95%
   
2. QOF Points Change: 14 → 38
   

1. CHOL004: Percentage of CHD, PAD, or Stroke/TIA patients with most recent cholesterol measurement in target range.
   
1. Threshold Change: 20%-35% (2024/25) → 20%-50% (2025/26)
   
2. QOF Points Change: 16 → 44
   

Action Points:

1. Identify patients at risk and establish recall systems for reviews.
   
2. Integrate cholesterol assessment and blood pressure actions into patient care pathways.
   
3. Train clinicians on new lipid management targets and best prescribing practices.
   

Adjusted QOF Achievement Thresholds

1. Higher reward for earlier intervention and risk stratification.
   
2. Focus on maintaining blood pressure and cholesterol levels within optimal ranges.
   
3. Lower thresholds for initial achievement but incentives for maintaining high standards.
   

Action Points:

1. Monitor achievement thresholds and adjust clinical priorities accordingly.
   
2. Ensure all at-risk patients receive timely reviews.
   
3. Develop action plans for patients requiring intensive management
   

Next Steps & Deadlines

1. April 2025 – New CVD prevention indicators come into effect.
   
2. Ongoing – Practices should monitor their achievement thresholds and optimise interventions.
   

Immediate Actions:

1. Review practice data to identify high-risk CVD patients.
   
2. Train teams on updated QOF indicators and new clinical targets.
   
3. Ensure recall and follow-up systems align with new CVD prevention standards.