HF006 - Heart Failure on a beta-blocker
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 a diagnosis of heart failure due to left ventricular systolic dysfunction or whose heart failure is due to reduced ejection fraction, who are currently treated with a beta-blocker licensed for heart failure. |
What do the business rules mean?
What makes a patient eligible?
Patients are eligible for the HF006 denominator if:
- they are on the Heart Failure register
and - they have a Left Ventricular Systolic Dysfunction or reduced ejection fraction code
It is worth reviewing patients who have an unresolved heart failure diagnosis to see if they should also have a Left Ventricular Systolic Dysfunction (LVSD) or reduced ejection fraction code, as if they are already on an beta-blocker (likely) this will boost your performance in this area.
How to achieve the indicator
To meet the criteria for HF006, eligible patients must have had:
- a prescription for a licenced b-blocker issued within 6 months of the end of the contract year
What will remove patients from being eligible?
- Patients who were issued an unlicenced beta blocker in the 6 months prior their heart failure diagnosis
- Patients who are currently on an unlicenced beta blocker
- Patients who have a persisting b-blocker (coded ever) or expiring b-blocker (in the contract year) contraindication
- Patients for whom heart failure quality indicator care was unsuitable in the contract year
- Patients who chose not to receive a b-blocker in the contract year
- Patients who chose not to receive heart failure quality indicator care in the contract year
- Patients who have been invited twice for review
- Patients who were diagnosed with heart failure in the last 3 months of the contract year
- Patients who were newly registered with the practice in the last 3 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.
Codes for heart failure due to left ventricular systolic dysfunction (LVSD) (HFLVSD_COD)
SNOMED code | SNOMED code description |
134401001 | Left ventricular systolic dysfunction |
407596008 | Echocardiogram shows left ventricular systolic dysfunction |
426263006 | Congestive heart failure due to left ventricular systolic dysfunction |
430396006 | Chronic systolic dysfunction of left ventricle |
698592004 | Asymptomatic left ventricular systolic dysfunction |
Reduced ejection fraction (heart failure) codes (REDEJCFRAC_COD)
SNOMED code | SNOMED code description |
703272007 | Heart failure with reduced ejection fraction |
703273002 | Heart failure with reduced ejection fraction due to coronary artery disease |
703274008 | Heart failure with reduced ejection fraction due to myocarditis |
703275009 | Heart failure with reduced ejection fraction due to cardiomyopathy |
703276005 | Heart failure with reduced ejection fraction due to heart valve disease |
Unlicensed beta-blocker prescription codes (ULBB_COD)
SNOMED code | SNOMED code description |
Beta-blocker contraindications (persisting) (XLBB_COD)
SNOMED code | SNOMED code description |
1053591000000102 | Nebivolol allergy |
1053601000000108 | Nebivolol adverse reaction |
1269396003 | Hypersensitivity to atenolol |
292419005 | Beta-adrenoceptor blocking drug adverse reaction |
292420004 | Cardioselective beta-blocker adverse reaction |
292421000 | Acebutolol adverse reaction |
292424008 | Betaxolol adverse reaction |
292425009 | Bisoprolol adverse reaction |
292426005 | Celiprolol adverse reaction |
292427001 | Esmolol adverse reaction |
292428006 | Metoprolol adverse reaction |
292429003 | Non-cardioselective beta-blocker adverse reaction |
292430008 | Nadolol adverse reaction |
292431007 | Pindolol adverse reaction |
292432000 | Carvedilol adverse reaction |
292433005 | Metipranolol adverse reaction |
292434004 | Carteolol adverse reaction |
292435003 | Labetalol adverse reaction` |
292436002 | Levobunolol adverse reaction |
292437006 | Oxprenolol adverse reaction |
292438001 | Penbutolol adverse reaction |
292439009 | Practolol adverse reaction |
292440006 | Propranolol adverse reaction |
292441005 | Sotalol adverse reaction |
292442003 | Timolol adverse reaction |
293962009 | Allergy to beta adrenergic receptor antagonist |
293963004 | Allergy to beta-1 adrenergic receptor antagonist |
293964005 | Allergy to acebutolol |
293965006 | Allergy to atenolol |
293966007 | Allergy to betaxolol |
293967003 | Allergy to bisoprolol |
293968008 | Allergy to celiprolol |
293969000 | Allergy to esmolol |
293970004 | Allergy to metoprolol |
293971000 | Non-cardioselective beta-blocker allergy |
293972007 | Allergy to nadolol |
293973002 | Allergy to pindolol |
293974008 | Allergy to carvedilol |
293975009 | Allergy to metipranolol |
293976005 | Allergy to carteolol |
293977001 | Allergy to labetalol |
293978006 | Allergy to levobunolol |
293979003 | Allergy to oxprenolol |
293980000 | Allergy to penbutolol |
293981001 | Allergy to practolol |
293982008 | Allergy to propranolol |
293983003 | Allergy to sotalol |
293984009 | Allergy to timolol |
418370000 | Atenolol adverse reaction |
419869001 | Atenolol sensitivity |
720665007 | Adverse reaction caused by metoprolol succinate |
720666008 | Adverse reaction caused by metoprolol tartrate |
772020009 | Adverse reaction caused by nebivolol |
772021008 | Allergy to nebivolol |
Beta-blocker contraindications (expiring) (TXLBB_COD)
SNOMED code | SNOMED code description |
315062004 | Beta blocker contraindicated |
315214003 | Beta blocker not indicated |
508741000000103 | Bisoprolol not indicated |
508771000000109 | Carvedilol not indicated |
508801000000107 | Nebivolol not indicated |
508831000000101 | Bisoprolol not tolerated |
508861000000106 | Carvedilol not tolerated |
508891000000100 | Nebivolol not tolerated |
698468005 | Bisoprolol contraindicated |
736004008 | Nebivolol contraindicated |
736006005 | Carvedilol contraindicated |
874932008 | Carvedilol not indicated |
874933003 | Nebivolol not indicated |
874934009 | Bisoprolol not indicated |
88201000000105 | Beta blocker not tolerated |
Codes for heart failure quality indicator care unsuitable for patient (HFPCAPU_COD)
SNOMED code | SNOMED code description |
717481000000104 | Excepted from heart failure quality indicators - patient unsuitable |
Codes indicating the patient has chosen not to receive beta blocker (LBBDEC_COD)
SNOMED code | SNOMED code description |
315020006 | Beta blocker therapy declined |
508921000000108 | Bisoprolol therapy refused |
508951000000103 | Carvedilol therapy refused |
698758004 | Nebivolol therapy declined |
Codes indicating the patient has chosen not to receive heart failure quality indicator care (HFPCADEC_COD)
SNOMED code | SNOMED code description |
717491000000102 | Excepted from heart failure quality indicators - informed dissent |
Invite for heart failure care review codes (HFINVITE_COD)
SNOMED code | SNOMED code description |
1109921000000106 | Quality and Outcomes Framework quality indicator-related care invitation |
1110931000000103 | Quality and Outcomes Framework heart failure quality indicator-related care invitation |
143411000000100 | Quality and Outcomes Framework heart failure quality indicator-related care invitation using preferred method of communication |
711461000000104 | Heart failure monitoring invitation |
716621000000101 | Heart failure monitoring third letter |
716971000000109 | Heart failure monitoring first letter |
717191000000108 | Heart failure monitoring second letter |
717501000000108 | Heart failure monitoring verbal invitation |
717531000000102 | Heart failure monitoring telephone invitation |
Related Articles
HF003 - Heart Failure on ACEi or ARB
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 HF003 In those patients with a diagnosis of heart failure due to left ...HF007 - Heart Failure review
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 HF007 The percentage of patients with a diagnosis of heart failure on the ...HF001 - Heart Failure register
The information contained within this article is from version 49 of the Business Rules for Quality and Outcomes Framework (QOF). This indicator is protected in the contract year 2024/25 and will be paid at 2023/24 performance levels Indicator ...HF008 - New Heart Failure diagnosis with echo or specialist assessment
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 HF008 The percentage of patients with a diagnosis of heart failure on or ...CHD001 - Coronary Heart Disease register
The information contained within this article is from version 49 of the Business Rules for Quality and Outcomes Framework (QOF). This indicator is protected in the contract year 2024/25 and will be paid at 2023/24 performance levels Indicator ...