Maximise QOF income: Blood pressure

GP Dr Gavin Jamie looks at how practices can attain maximum points within the blood pressure area of QOF’s public health domain

Summary – indicators and value

• Indicators: 1
• Points: 15
• Prevalence: N/A
• £/patient (estimated): £0.80

Indicator BP002: The percentage of patients over 45 who have a record of blood pressure in the preceding 5 years (15 points)

Clinically, this is a fairly simple indicator – all patients over the age of 45 at the end of the QOF year should have had a blood pressure measurement in the preceding five years.

Patients at the younger end of the range may have had the measurement as young as 40 and this will be counted after their 45th birthday.

It is hard to advise on the likely financial value of this to practices. It is worth about 90p per patient per year to a typical practice. As there is no prevalence adjustment, practices with an older population will get a little less per patient.

However, remember each measurement can also apply for five QOF years. So a reading now could earn £4 over five years. This is a good return for a relatively quick procedure.

Key points:

• Blood pressure measurement is part of the NHS Health Check which applies to patients from age 40 to 74 years and can be repeated on a five-yearly cycle.
• Patients with existing diabetes or cardiovascular disease don’t qualify for a health check but are still counted in this indicator. For most of these patients blood pressure should be measured more frequently as part of other QOF process indicators. Concentrating on these outcomes indicators will ensure that the blood pressure is measured as well as earning the health check fee.
• Patients aged 75 and over do not qualify for a health check but this age group are more likely to visit the practice. It is useful to have appropriate alerts on the computer system. Automatic blood pressure machines allow non-clinical staff to take a reading with appropriate protocols about what to do following an abnormal reading.
• Some patients may also have blood pressure taken in outpatient clinics or other settings – ensuring that this is coded will boost achievement.
• Patients that are identified as having hypertension can be added to that register and so will attract payment for the additional prevalence.
• Personalised care adjustment (previously exception reporting) is unlikely to apply often, although patients can be coded if the blood pressure is refused.

Dr Gavin Jamie is a GP in Swindon and runs the QOF database website

Further reading/resources

• NHS England – Quality and Outcomes Framework guidance for 2023/24. Published 30 March 2023.