DM033 - Diabetes, not frail, with BP 140/90mmHg or less (Retired v50 2025/26)
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.
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, without moderate or severe frailty in whom the last blood pressure reading (measured in the preceding 12 months) is 140/90mmHg or less (or equivalent home blood pressure reading). |
What do the business rules mean?
What makes a patient eligible?
Patients are eligible for the DM033 denominator if they:
- are on the Diabetes register
- have not been classified as living with moderate or severe frailty
How to achieve the indicator.
To meet the criteria for DM033, eligible patients must have met one of the following requirements:
- a latest blood pressure measured in clinic (ie: one that is not ambulatory or home-based) that was at most 140/90mmHg
- a latest blood pressure which was from an ambulatory test that was at most 135/85mmHg
- a latest blood pressure measured at home by the patient that was at most 135/85mmHg
What will remove patients from eligibility?
- Patients who have been coded as receiving maximal blood pressure therapy in the contract year
- Patients for whom diabetes quality care was coded unsuitable in the contract year
- Patients who chose not to have their blood pressure recorded or undertake home blood pressure or ambulatory blood pressure monitoring in the contract year
- Patients who chose not to receive diabetes quality indicator care in the contract year
- Patients who have been invited twice (at least 7 days apart) for review with no subsequent blood pressure reading
- Patients whose most recent BP reading in the contract year was followed by two invites at least 7 days apart (ie: a raised result which needs re-checking)
- Patient who were diagnosed with diabetes in the last 9 months of the contract year
- 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.
What are the common pitfalls/what do I need to watch out for?
Separately coded systolic and diastolic values (especially for a clinic based reading) may not be counted towards the indicator.
- Ensure all clinicians are aware of the coding requirements.
- Ensure all clinicians are aware of the blood pressure target thresholds and their impact on the indicator, especially towards the end of the contract year.
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.
Codes for clinic blood pressure readings (CLINBP_COD)
SNOMED code | SNOMED code description |
163020007 | On examination - blood pressure reading |
| 75367002 | Blood pressure |
| 163034007 | Standing blood pressure |
| 163035008 | Sitting blood pressure |
| 163033001 | Lying blood pressure |
Codes for home blood pressure readings (HOMEAMBBP_COD)
SNOMED code | SNOMED code description |
1162737008 | Self reported systolic blood pressure |
| 1162735000 | Self reported diastolic blood pressure |
| 413606001 | Average home systolic blood pressure |
| 413605002 | Average home diastolic blood pressure |
| 314446007 | Average day interval systolic blood pressure |
| 314461008 | Average day interval diastolic blood pressure |
| 314449000 | Average 24 hour systolic blood pressure |
| 314462001 | Average 24 hour diastolic blood pressure |
| 198081000000101 | Ambulatory systolic blood pressure |
| 198091000000104 | Ambulatory diastolic blood pressure |
Codes for maximal blood pressure (BP) therapy (HTMAX_COD)
SNOMED code | SNOMED code description |
407567007 | Patient on maximal tolerated antihypertensive therapy |
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 have blood pressure procedure (BPDEC_COD)
SNOMED code | SNOMED code description |
413123006 | Blood pressure procedure declined |
Codes indicating patient chosen not to undertake home blood pressure measurement (HBPM) (HOMEBPDEC_COD)
SNOMED code | SNOMED code description |
1085031000000100 | Home blood pressure monitoring declined |
Codes indicating patient chosen not to undertake ambulatory blood pressure monitoring (ABPM) (ABPMDEC_COD)
SNOMED code | SNOMED code description |
861231000000105 | Ambulatory blood pressure recording 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 |
310425007 | Diabetes monitoring invitation |
1083111000000108 | Diabetes monitoring invitation email |
185756006 | Diabetes monitoring first letter |
185757002 | Diabetes monitoring second letter |
185758007 | Diabetes monitoring third letter |
705072004 | Diabetes monitoring invitation 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 |
185760009 | Diabetes monitoring telephone invite |
185759004 | Diabetes monitoring verbal invite |
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 |
1109921000000106 | Quality and Outcomes Framework quality indicator-related care invitation |