DM021 - Diabetes (frail) with HbA1c less than or equal to 75

DM021 - Diabetes (frail) with HbA1c less than or equal to 75

The information contained within this article is from version 49 of the Business Rules for Quality and Outcomes Framework (QOF).                                                                     

Indicator definition

Indicator ID

Description

The percentage of patients with diabetes, on the register, with moderate or severe frailty in whom the last IFCC-HbA1c is 75 mmol/mol or less in the preceding 12 months.

What do the business rules mean?

What makes a patient eligible?

Patients are eligible for the DM021 denominator if they:
  1. are on the Diabetes register
  2. are living with moderate or severe frailty

How to achieve the indicator

To meet the criteria for DM021, eligible patients must have had:
  1. an HbA1c in the contract year that is less than or equal to 75

What will remove patients from eligibility?

  1. Patients who do not have an HbA1c recorded during this contract year, but they do have a serum fructosamine result recorded
  2. Patients who are coded for maximal tolerated diabetes treatment in the contract year
  3. Patients for whom diabetes quality indicator care was unsuitable in the contract year
  4. Patients who chose not to receive a blood test in the contract year
  5. Patients who chose not to receive diabetes quality indicator care in the contract year
  6. Patient who have been invited twice (at least 7 days apart) for review with no subsequent HbA1c result
  7. Patients whose most recent HbA1c result in the contract year was followed by two invites at least 7 days apart (ie: a 6 month review or a raised result which needs re-checking)
  8. Patients who were diagnosed with diabetes in the last 9 months of the contract year
  9. Patients who were newly registered with the practice in the last 9 months of the contract year

If a patient achieves the indicator at any point during the year, any exclusions that have also been added are ignored.

SNOMED codes used in this indicator

The codes referenced in this article are taken from the NHS Technology Reference Update Distribution (TRUD).  Not all of these may be present or selectable in all clinical systems.

Serum fructosamine codes (SERFRUC_COD)

SNOMED code

SNOMED code description

1006751000000102

Serum fructosamine level

13711000237108
Substance concentration of fructosamine in serum
14201000237100
Substance concentration of fructosamine in plasma

Codes for maximum tolerated diabetes treatment (DMMAX_COD)

SNOMED code

SNOMED code description

407569005

Patient on maximal tolerated therapy for diabetes

Codes for diabetes quality indicator care unsuitable for patient (DMPCAPU_COD)

SNOMED code

SNOMED code description

717421000000100

Excepted from diabetes quality indicators - patient unsuitable

Codes indicating the patient has chosen not to receive a blood test (BLDTESTDEC_COD)

SNOMED code

SNOMED code description

116471000119100

Blood test declined

Codes indicating the patient has chosen not to receive diabetes quality indicator care (DMPCADEC_COD)

SNOMED code

SNOMED code description

716031000000106

Excepted from diabetes quality indicators - informed dissent

Invite for diabetes care review codes (DMINVITE_COD)

SNOMED code
SNOMED code description
1109921000000106
Quality and Outcomes Framework quality indicator-related care invitation
1110921000000100
Quality and Outcomes Framework diabetes mellitus quality indicator-related care invitation
143401000000102
Quality and Outcomes Framework diabetes mellitus quality indicator-related care invitation using preferred method of communication
705072004
Diabetes monitoring invitation by short message service text messaging

1066911000000100

Diabetes monitoring short message service text message first invitation

1066921000000106
Diabetes monitoring short message service text message second invitation
1066931000000108
Diabetes monitoring short message service text message third invitation
1083111000000108
Diabetes monitoring invitation email
185756006
Diabetes monitoring first letter
185757002
Diabetes monitoring second letter
185758007
Diabetes monitoring third letter
185759004
Diabetes monitoring verbal invite
185760009
Diabetes monitoring telephone invite
310425007
Diabetes monitoring invitation

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