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Cardiovascular disease - primary prevention (CVD-PP) QOF tips

Dr Gavin Jamie provides advice on meeting the targets in this domain, plus details of the indicators for 2013/14.

All patients will be on the hypertension register (Picture: Jim Varney)
All patients will be on the hypertension register (Picture: Jim Varney)

Tips for improving achievement

GP Dr Gavin Jamie writes:

This area is really just a subset of the main blood pressure area. All of the patients here will also appear on the hypertension register.

The first indicator only applies to patients newly diagnosed with hypertension since the previous April. Only patients who have not had a previous diagnosis of coronary heart disease, familial hypercholesterolaemia, stroke, diabetes or chronic kidney disease will qualify.

For 2013/14 there is no longer an indicator that specifically asks for a risk assessment. This has been replaced by an indicator about treatment on the result of that assessment.

If the assessment shows that the patient has a 10-year risk of over 20% then a statin should be prescribed. As usual only prescriptions issued after 1 October will be counted for up to 10 points.

The second indicator applies to everyone who has been diagnosed with hypertension since April 2009, even if that was in another practice.

Every year these patients should receive lifestyle advice about smoking, a healthy diet and and safe alcohol consumption. Although there are specific codes for each of these areas the only codes that count are the 67H and 67H8 codes. There are 5 points for this.

More advice

Hertfordshire GP Professor Mike Kirby says the key to improving achievement in assessing risk among newly diagnosed patients with hypertension is allocating time in advance to conduct the risk assessment.

‘This is a very important indicator, and one where there is room for improvement,’ he says. ‘It takes time to do a risk assessment: you've got to access the risk assessment tool, input all the data and have access to the data, such as cholesetrol. HbA1c ratio, BP etc.'

'It's not a five minute job,' he adds. 'You have to explain the importance to at-risk patients. There's no point doing it if you don't spend time talking to them.’

Current indicators

Cardiovascular disease - primary prevention (CVD-PP) indicators
Points Achievement thresholds

CVD-PP001: In those patients with a new diagnosis of hypertension aged 30 or over and who have not attained the age of 75, recorded between the preceding 1 April to 31 March (excluding those with pre-existing CHD, diabetes, stroke and/or TIA), who have a recorded CVD risk assessment score (using an assessment tool agreed with NHS England) of ≥20% in the preceding 12 months (15 months in Wales and N Ireland): the percentage who are currently treated with statins.

10

40-90%

CVD-PP002: The percentage of patients diagnosed with hypertension (diagnosed on or after 1 April 2009) who are given lifestyle advice in the preceding 12 months for: smoking cessation, safe alcohol consumption and healthy diet.

5

40-75%

Scotland only
CVD-PPOO3(S)
The patients diagnosed with hypertension (diagnosed on or after 1 April 2009) who require lifestyle advice on increasing physical activity, as identified in CVD-PP002(S), in the preceding 12 months are given that advice utilising the Scottish Physical Activity Screening Questions (Scot-PASQ).

5

 

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