GP Dr Gavin Jamie looks at how practices can attain maximum points within the peripheral arterial disease area of QOF’s clinical domain
Summary – indicators and value
- Indicators: 1
- Points: 2
- Prevalence: 0.6% (this is an estimate based on latest available QOF data and current trends)
- £/patient on the register (estimated.): £7.50
Peripheral arterial disease (PAD) has only been part of the QOF for six years. The prevalence has been falling slowly over that time, presumably due to improvements in the management of risk factors, such as diabetes and smoking.
Patients with PAD are likely to have other arterial conditions such as heart disease or stroke. For this reason, all of the indicators other than the register itself were removed in 2019/20.
Indicator PAD001: Maintain patient register (2 points)
Coding PAD, including intermittent claudication, will qualify a patient for the register. There is no code to remove a patient from the register – clinically this is not a condition that would be expected to resolve, although improvement is achievable.
There are not really any specific patterns of prescribing that would easily identify patients that might be missing a diagnostic code. However, these patients are likely to have other vascular disease or diabetes. Patients with diabetes who have had poor foot pulses noted on their annual check should be considered for further investigation, and therefore possible PAD.
While there are no lab tests that would identify PAD, searching for Doppler test results can identify patients who have not had a diagnostic code for PAD. This is considerably easier if Doppler results are entered using a template with appropriate codes.
Dr Gavin Jamie is a GP in Swindon and runs the QOF Database website
NHS England – Quality and Outcomes Framework guidance for 2023/24. Published 30 March 2023.