🫀 Simple Contract AF 2025/26

💷 How much is this worth to me?

This template supports achievement of two AF-related indicators in QOF 2025/26:

• AF006 – Recording a CHA₂DS₂-VASc score in eligible patients

• AF008 – Prescribing appropriate anticoagulation in those with a CHA₂DS₂-VASc score ≥2

Meeting both indicators contributes directly to your QOF income and may also support local enhanced service (LES) requirements where these overlap. Inaccurate coding or missed exemptions can lead to lost income or contract breaches.

📊 High-level overview of the specification requirements

AF006: CHA₂DS₂-VASc Risk Score

You must record a valid CHA₂DS₂-VASc score for patients with AF. Each component must be correctly coded in the record for the score to be calculated.

AF008: Anticoagulation

To meet this indicator, patients with AF (and CHA₂DS₂-VASc ≥2) must be anticoagulated unless a valid exclusion applies. This includes:

• Prescribing a DOAC

• Prescribing warfarin plus either:

  • Documented informed dissent for DOACs

  • DOAC contraindication

  • Diagnosis of antiphospholipid syndrome

  • TTR > 65% with documented reason for using warfarin

Patients with a mechanical heart valve must be on warfarin to count as achieving the indicator.

📌 What do you need to know?

This template includes all key elements to support contract delivery:

🧮 CHA₂DS₂-VASc Calculation (AF006)

Automated scoring based on coded entries for:

• C – Congestive heart failure

• H – Hypertension

• A – Age ≥75 (2 points) or 65–74 (1 point)

• D – Diabetes

• S – Stroke/TIA/thromboembolism

• V – Vascular disease

• Sc – Sex category (female)

➡️ Double-check underlying codes are accurate — the score is only as reliable as the coded data.

💊 Anticoagulation Decisions (AF008)

• DOACs (preferred) or warfarin with valid reasons

• For warfarin users: ensure TTR is recorded in the last 6 months

• Document relevant exceptions if anticoagulation is not appropriate

🚫 Personalised Care Adjustments (PCAs)

PCAs can be recorded:

• At the item level (e.g. DOAC contraindicated)

• At the bottom of the template to remove patients from the disease register or apply invitation exemptions

💡 Hints and Tips

• DOAC exemptions must be explicit — use the provided codes for dissent, contraindications, or clinical inappropriateness.

• TTR must be recorded within 6 months of the contract year for warfarin patients.

• Use the bottom section of the template to record full register removals or invitation exemptions (e.g. 2 invites 7+ days apart).

• Consider prompting CHA₂DS₂-VASc scoring during annual reviews to avoid gaps.

• The template also flags if patients refuse DOACs or have adverse reactions, enabling correct use of temporary or permanent exclusions.