NDH003 - HbA1c monitoring
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 51 of the Business Rules for Quality and Outcomes Framework (QOF).
Indicator definition
Indicator ID | Description |
The percentage of patients with non-diabetic hyperglycaemia or a previous diagnosis of gestational diabetes (GDM) 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 NDH003 denominator if:
- they have a diagnosis of Non-Diabetic Hyperglycaemia (including Pre-Diabetes and Impaired glucose tolerance codes) or Gestational diabetes (GDM)
or - they had a diagnosis of NDH or Gestational diabetes 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 NDH003, eligible patients must:
- have an HbA1c or fasting plasma glucose result recorded in the contract year
What will remove patients from eligibility?
- Patients have NDH diagnosis for whom non diabetic hyperglycaemia quality indicator care was unsuitable in the contract year
- Patients have GDM diagnosis for whom gestational diabetes quality indicator care was unsuitable in the contract year
- Patients who chose not to have a glucose test in the contract year
- Patients who have NDH and chose not to receive non diabetic hyperglycaemia quality indicator care in the contract year
- Patients who have GDM who chose not to receive gestational diabetes quality indicator care in the contract year
- Patients who were invited twice for review (at least 7 days apart) within the contract year for NDH (if they have this) or GDM (if they have this)
- Patients who were diagnosed with non diabetic hyperglyaemia or GDM 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.
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.
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 (NDH_COD)
| SNOMED code | SNOMED code description |
700449008 | Non-diabetic hyperglycaemia |
Codes for prediabetes (PRD_COD)
SNOMED code | SNOMED code description |
858301000000107 | Pre-diabetes |
714628002 | Prediabetes |
16896421000119107 | Prediabetes in mother during pregnancy |
Codes for impaired glucose tolerance (IGT_COD)
SNOMED code | SNOMED code description |
| 22910008 | Impaired glucose tolerance in obese |
| 390951007 | Impaired fasting glycaemia |
| 849171000000106 | Impaired glucose regulation |
| 88512005 | Impaired glucose tolerance associated with insulin receptor abnormality |
| 32284009 | Impaired glucose tolerance in nonobese |
| 1822007 | Impaired glucose tolerance associated with pancreatic disease |
| 128264007 | Impaired glucose tolerance with hyperinsulism |
| 73480000 | Impaired glucose tolerance associated with hormonal aetiology |
| 9414007 | Impaired glucose tolerance |
| 1310004 | Impaired glucose tolerance associated with genetic syndrome |
Codes for gestational diabetes (GESTDIAB_COD)
SNOMED code | SNOMED code description |
| 472699005 | Uncontrolled gestational diabetes mellitus |
| 75022004 | Gestational diabetes mellitus class A1 |
| 40791000119105 | Postpartum gestational diabetes mellitus |
| 40801000119106 | Gestational diabetes mellitus complicating pregnancy |
| 11687002 | Gestational diabetes mellitus |
| 10753491000119101 | Gestational diabetes mellitus in childbirth |
| 46894009 | Gestational diabetes mellitus class A2 |
| 472971004 | Past pregnancy history of gestational diabetes mellitus |
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 for gestational diabetes quality indicator care unsuitable for patient (GESTIABPU_COD)
Codes not currently available
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 |
Codes indicating the patient has chosen not to receive gestational diabetes quality indicator care (GESTDIABPCADEC_COD)
Codes not currently available
Invite for non diabetic hyperglycaemia care review codes (NDHINVITE_COD)
| SNOMED code | SNOMED code description |
| 148561000000109 | QOF (Quality and Outcomes Framework) non-diabetic hyperglycaemia quality indicator-related care invitation |
| 1109921000000106 | QOF (Quality and Outcomes Framework) quality indicator-related care invitation |
148571000000102 | QOF (Quality and Outcomes Framework) non-diabetic hyperglycaemia quality indicator-related care invitation using preferred method of communication |
Invite for gestational diabetes care review codes (GESTDIABINVITE_COD)
Codes not currently available