Annex D – QOF Technical Changes (2025/26)

Annex D – QOF Technical Changes (2025/26)

Overview

Notes
Annex D details the technical changes to the Quality and Outcomes Framework (QOF) for 2025/26, including adjustments to indicator specifications, coding updates, and changes in data validation requirements. These modifications impact how practices record, report, and claim QOF payments.

 Key QOF Technical Changes for 2025/26

Below are the technical amendments to key QOF indicators:

Current ID

Current Indicator

New ID

New Indicator

Technical Change & Rationale

CHOL003

Percentage of patients on the QOF Coronary Heart Disease, Peripheral Arterial Disease, Stroke/TIA or Chronic Kidney Disease Register who are currently prescribed a statin, or where a statin is declined or clinically unsuitable, another lipid-lowering therapy

CHOL003

Percentage of patients on the QOF Coronary Heart Disease (CHD), Peripheral Arterial Disease (PAD), Stroke/Transient Ischaemic Attack (TIA) or Chronic Kidney Disease (CKD) Register who are currently prescribed a statin, or where a statin is declined or clinically unsuitable, another lipid-lowering therapy

Removed icosapent ethyl from the other lipid-lowering therapies cluster as NICE only recommends it for use with, rather than instead of, a statin.

CHOL004

Percentage of patients on the QOF CHD, PAD, or Stroke/TIA Register, who have a recording of LDL (Low-density Lipoprotein) cholesterol in the preceding 12 months that is 2.0 mmol/L or lower, or where LDL cholesterol is not recorded, a recording of non-HDL (High-density Lipoprotein) cholesterol in the preceding 12 months that is 2.6 mmol/L or lower.

CHOL004

Percentage of patients on the QOF CHD, PAD, or Stroke/TIA Register, with the most recent cholesterol measurement in the preceding 12 months, showing as ≤ 2.0 mmol/L if it was an LDL cholesterol reading or ≤ 2.6 mmol/L if it was a non-HDL cholesterol reading. For multiple readings on the latest date, the LDL reading takes priority.

Adjusted to align with NICE Indicator IND278 for cholesterol treatment target measurement.

DM022

The percentage of patients with diabetes aged 40 years and over, with no history of cardiovascular disease and without moderate or severe frailty, who are currently treated with a statin (excluding patients with type 2 diabetes and a CVD risk score of <10% recorded in the preceding 3 years)

DM034

The percentage of patients with diabetes, on the register, aged 40 years or over, with no history of CVD and without moderate or severe frailty, who are currently treated with a statin, or where a statin is declined or clinically unsuitable, another lipid-lowering therapy.

Other lipid-lowering therapy cluster added to align with updated NICE Indicator IND275.

DM023

The percentage of patients with diabetes and a history of cardiovascular disease (excluding haemorrhagic stroke) who are currently treated with a statin.

DM035

The percentage of patients with diabetes, on the register and a history of CVD (excluding haemorrhagic stroke) who are currently treated with a statin, or where a statin is declined or clinically unsuitable, another lipid-lowering therapy.

Other lipid-lowering therapy cluster added to align with updated NICE Indicator IND276.

DM033

The percentage of patients with diabetes, on the register, without moderate or severe frailty in whom the last blood pressure reading (measured in the preceding 12 months) is 140/90 mmHg or less (or equivalent home blood pressure reading).

DM036

The percentage of patients with diabetes, on the register, aged 79 years and under without moderate or severe frailty in whom the last blood pressure reading (measured in the preceding 12 months) is 140/90 mmHg or less (or equivalent home blood pressure reading).

Added ‘79 years and under’ to align with updated NICE Indicator IND249.

AST011

The percentage of patients with a diagnosis of asthma on or after 1 April 2023 with objective testing within 6 months of diagnosis.

AST012

The percentage of patients with a new diagnosis of asthma on or after 1 April 2025 with a record of an objective test between 3 months before or 3 months after diagnosis.

Removed reliance on spirometry as the main objective test to align with NICE Guideline NG25.

AST007

The percentage of patients with asthma on the register, who have had an asthma review in the preceding 12 months that includes an assessment of asthma control using a validated asthma control questionnaire, a recording of the number of exacerbations, an assessment of inhaler technique and a written personalised action plan.

AST007

The percentage of patients with asthma on the register, who have had an asthma review in the preceding 12 months that includes an assessment of asthma control, a recording of the number of exacerbations, an assessment of inhaler technique and a written personalised action plan.

Removed requirement for validated asthma control questionnaire to align with NICE Guideline NG25.

AF008

Percentage of patients on the QOF Atrial Fibrillation register and with a CHA2DS2-VASc score of 2 or more who were prescribed a direct-acting oral anticoagulant (DOAC), or, where a DOAC was declined or clinically unsuitable, a Vitamin K antagonist.

AF008

Percentage of patients on the QOF Atrial Fibrillation register and with a CHA2DS2-VASc score of 2 or more, who were prescribed a direct-acting oral anticoagulant (DOAC), or, where a DOAC was declined or clinically unsuitable, a Vitamin K antagonist.

Invite PCA added in response to feedback, to align with indicators of a similar type.


Action Points:

  1. Ensure clinical IT systems are updated to reflect new QOF technical requirements.
  2. Train staff on coding and reporting updates.
  3. Review exception reporting changes to maintain compliance.


Next Steps & Deadlines

  1. April 2025 – QOF technical changes take effect.
  2. Ongoing – Practices must monitor compliance with updated reporting standards.

Immediate Actions:

  1. Confirm IT system readiness for QOF technical updates.
  2. Train clinical and administrative teams on new coding and reporting rules.
  3. Ensure exception reporting aligns with 2025/26 guidelines.