NDH002 - HbA1c monitoring

NDH002 - HbA1c monitoring

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 non-diabetic hyperglycaemia who have had an HbA1c or fasting blood glucose performed in the preceding 12 months.

What do the business rules mean?

What makes a patient eligible?

Patients are eligible for the NDH002 denominator if:
  1. they have a diagnosis of Non-Diabetic Hyperglycaemia (including Pre-Diabetes and Impaired glucose tolerance codes)
    or
  2. they had a diagnosis of NDH at the beginning of the contract year, but subsequently have been diagnosed with diabetes during this contract year

How to achieve the indicator

To meet the criteria for MH012, eligible patients must:
  1. have an HbA1c or glucose result recorded in the contract year

What will remove patients from eligibility?

  1. Patients for whom non diabetic hyperglycaemia quality indicator care was unsuitable in the contract year
  2. Patients who chose not to have a glucose test in the contract year
  3. Patients who chose not to receive non diabetic hyperglycaemia quality indicator care in the contract year
  4. Patients who were invited twice for review (at least 7 days apart) within the contract year
  5. Patients who were diagnosed with non diabetic hyperglyaemia in the last 3 months of the contract year
  6. 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.

What are the common pitfalls/what do I need to watch out for?

Patients who have been diagnosed with diabetes during this contract year appear in both the NDH register (NDH_REG) and the Diabetes register. The patient will stay on the NDH register for the remainder of this contract year, and will then drop off on the next 1st April.
Think of this as having monitoring work for NDH recognised, as HbA1c monitoring would have indicated the diabetes diagnosis.

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 non diabetic hyperglycaemia quality indicator care unsuitable for patient (NDHPU_COD)

SNOMED code

SNOMED code description

148551000000106

Excepted from non-diabetic hyperglycaemia quality indicators - patient unsuitable

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

SNOMED code

SNOMED code description

698473004

Blood glucose test declined

Codes indicating the patient has chosen not to receive non diabetic hyperglycaemia quality indicator care (NDHPCADEC_COD)

SNOMED code

SNOMED code description

148541000000108

Excepted from non-diabetic hyperglycaemia quality indicators - informed dissent

Invite for non diabetic hyperglycaemia care review codes (NDHINVITE_COD)

SNOMED code

SNOMED code description

1109921000000106

Quality and Outcomes Framework quality indicator-related care invitation

148561000000109
Quality and Outcomes Framework non-diabetic hyperglycaemia quality indicator-related care invitation
148571000000102
Quality and Outcomes Framework non-diabetic hyperglycaemia quality indicator-related care invitation using preferred method of communication


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