Heart Failure forms part of the clinical domains area of QOF.


There are 2 Heart Failure registers for the purpose of calculating practice prevalence:


HF1_REG - patients diagnosed with heart failure and no unresolved heart failure code.


HF2_REG - patients with heart failure due to left ventricular systolic dysfunction (LSVD) or reduced ejection fraction and no unresolved heart failure code.


Please note - that register 2 is a sub set of register 1, therefore, there will be patients that appear on both registers.


There are 5 Heart Failure QOF indicators:


HF001 (Register - HF1_REG) – includes patients with a heart failure diagnosis.

 

HF003 (Register - HF2_REG) – for patients with a diagnosis of heart failure due to left ventricular systolic dysfunction (or reduced ejection fraction), they should be treated with either an ACE- I or ARB. This indicator is looking for the medication to be issued in the last 6 months of the fiscal year.

 

A personalised care adjustment (PCA) can be applied if the patient has a contraindication or decline code for BOTH medications.


HF006 (Register - HF2_REG)  for patients with a diagnosis of heart failure due to left ventricular systolic dysfunction (or reduced ejection fraction), they should be treated with a beta blocker licensed for heart failure. This indicator is looking for the medication to be issued in the last 6 months of the fiscal year.

 

A PCA can be applied if the patient has a contraindication or decline code, or they were issued an unlicensed beta blocker in the 6 months before the diagnosis.


HF007 (Register - HF1_REG)  includes patients on the heart failure register who have had a review this fiscal year.  The review must include an assessment of functional capacity and a review of medication.

 

PCA can be applied if the patient declines a medication review this fiscal year.


HF008 (Register HF1_REG) – patients with a diagnosis of heart failure after 1/4/23 should have this confirmed by an echo or specialist assessment in the 6 months before diagnosis.  If the patient is newly registered to the practice and no echo or specialist assessment has been done, then this can be done within 6 months of the date of registration with your practice.

 

PCA applies if the patient registers within the last 6 months of the fiscal year and they were diagnosed at their previous practice, or if they were diagnosed at a previous practice and they are coded as echo unsuitable or heart failure indicator care unsuitable within 6 months of registering at the new practice, or if the patient has a palliative care code on their records after 1/4/2008.  Patients are also removed from the denominator population for this indicator if they have been diagnosed or registered at the practice within the last 3 months of the fiscal year.

 

Please note – fpatients will be removed from the denominator population if they meet and have been appropriability coded with the following:

  • not responded to 2 invitation codes (invitation codes must be 7 days apart).
  • they have been newly diagnosed with heart failure in the last 3 months of the fiscal year.
  • they have been newly registered at the practice in the last 3 months of the fiscal year.
  • they have a heart failure quality informed dissent code recorded this fiscal year.
  • they have a heart failure quality unsuitable code recorded this fiscal year.


Achievement

 

Indicator

Points

Threshold

HF001. The contractor establishes and maintains a register of patients with heart failure

4

N/A

HF003. In those patients with a diagnosis of heart failure due to left ventricular systolic dysfunction or whose heart failure is due to reduced ejection fraction the percentage of patients who are currently treated with an angiotensin-converting enzyme inhibitor (ACE-I) or Angiotensin II receptor blockers (ARB).

6

60 – 92%

HF006. 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.

6

60 – 92%

HF007. The percentage of patients with a diagnosis of heart failure on the register, who have had a review in the preceding 12 months, including an assessment of functional capacity and a review of medication to ensure medicines optimisation at maximal tolerated doses.

7

50 – 90%

HF008. The percentage of patients with a diagnosis of heart failure on or after 1 April 2023 which: 1. Has been confirmed by an echocardiogram or by specialist assessment in the 6 months before entering on to the register; or 2. If registered at the practice after diagnosis, with no record of the diagnosis originally being confirmed either by echocardiogram or by specialist assessment, a record of an echocardiogram or a specialist assessment within 6 months of the date of registration.

6

50 – 90%

 

Ardens EMIS Resources to support Heart Failure for QOF

 

Clinical Templates

The following template are available to support staff with recording QOF activity for heart failure patients.

  • Chronic Disease Templates - the Ardens Heart Failure template contains a QOF only page for capturing all the QOF requirements for the current financial year.
  • Multi-Morbidity Templates – for patients with multiple long-term conditions and to capture all QOF requirements for all conditions relevant to the specific patient.

 

Searches

The following searches are available to support staff with achieving your QOF cancer indicators.

  • QOF Misc Searches - includes searches to identify patients that have not had the full elements of their annual review.
  • Case Finders Searches - contains a suite of searches to identify potential heart failure patients missing from your practice QOF register.
  • Time Sensitive QOF Searches – searches to help achieve the HF008 time limited indicator.
  • QOF Monitor Dashboard – works with the Ardens Manager QOF dashboard to allow a visual of QOF performance in monetary and points values.

 

QOF Alerts

The following are examples of real-time alerts available by default to alert practice staff of data quality issues which are affecting the heart failure QOF achievement.

 



If you require any further assistance on the process above, please contact Ardens support on: support-emis@ardens.org.uk