🫁 Simple Contract Asthma Diagnosis 2025/26

💷 How much is this worth to me?

This template ensures that new asthma diagnoses meet the diagnostic evidence requirements in QOF indicator AST011/AST012. Correct use of this template:

• Secures QOF income by validating asthma diagnoses with appropriate tests

• Prevents patients being inappropriately included in the asthma register (which could affect performance on other indicators like AST007)

• Avoids audit issues where unresolved diagnoses have no supporting evidence

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📊 High-level overview of the specification requirements

AST012: Confirmed Asthma Diagnosis

For a diagnosis to count in QOF, the patient must have supporting test evidence coded within 3 months before or after the earliest unresolved asthma diagnosis.

Requirements differ slightly based on age:

• Age 16+: Only one of the following is needed:

  • Full blood count (FBC) for eosinophils

  • FeNO test

  • Bronchodilator reversibility with spirometry

  • Peak flow variability (if spirometry unavailable)

  • Bronchial challenge test

• Under 16s: One of the following is needed:

  • FeNO test

  • Bronchodilator reversibility with spirometry

  • Peak flow variability (if spirometry unavailable)

  • Skin prick test to house dust mite

  • Total IgE and eosinophil count

  • Bronchial challenge test

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📌 What do you need to know?

This template guides you through each step of confirming a diagnosis:

🧪 Diagnostic Evidence

Separate sections for:

• Age 16+: Tick the diagnostic test that has been done

• Under 16: Slightly broader list, with additional allergy testing options

You only need one coded test per diagnosis window for QOF.

❗ Exemption Coding

• Use the Exception Reporting section at the bottom to document if the patient is unsuitable or has declined asthma monitoring

• Codes here will exclude the patient from all asthma-related QOF indicators

📬 Patient Invitations

• Invitation codes are provided to support PCA exemption rules (e.g. two invites at least 7 days apart)

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💡 Hints and Tips

• If no diagnostic evidence is recorded, the patient will remain on the unresolved asthma register and QOF income may be lost

• Tests must be within 3 months either side of the diagnosis — use diary dates and reminders if waiting for results

• Use the template when reviewing historic diagnoses to validate or exception code if no evidence is available

• Some diagnostic codes are still being finalised — keep the template updated with local or national guidance

• Remember: confirmation is not just good practice — it's contractually required for QOF!