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Hypertension (HYP) QOF tips

Dr Gavin Jamie offers advice on meeting the targets in this area, plus details of indicators and achievement thresholds for 2013/14.

Practices in England and Wales face tougher treatment targets
Practices in England and Wales face tougher treatment targets

Tips for improving achievement

GP Dr Gavin Jamie writes:

Hypertension is the QOF area with the highest prevalence, almost 14% of the total population, and this is partially reflected in the 77 points it attracts in England.

Six of these points are for compiling the register in the first place. The vast majority of the points are, predictably for treating patients to blood pressure targets. There are two targets which are based on the age of the patient at the end of the QOF year.

Hypertension is one of the QOF areas which has seen significant divergence between the UK countries. In Scotland, the domain remains the same in 2013/14 as it was in 2012/13. Meanwhile, Wales and England both have one new indicator relating to tougher blood pressure targets, while England has two further new indicators relating to physical activity.

Treatment targets
For patients of all ages there are ten points (in England and Wales) for getting the blood pressure below 150/90. As usual only the last reading of the QOF year counts so one tactic is to keep measuring until the target is hit and then stop. Only readings after the first of July count for the indicator.

The second target only applies to patients who have not reached their 80th birthday before the end of the QOF year. There are fifty points available for practices in England and 45 for those in Wales and the systolic target is tougher - 140/90. The same timing rules apply as the previous indicator.

The two indicators introduced for England only are about encouraging exercise in patients. The GPPAQ questionnaire (not to be confused with the GPAAQ practice survey which was used a few years ago) should be answered by all patients who are under 70 years old on 31 March.

The score can be calculated fairly simply. While the full version of the questionnaire has many questions only three are used in the calculation. There are only five points for available for a large number of patients here.

If the score is less than 'active' then there should be a 'brief intervention' - basically a recommendation to undertake more exercise. It is worth remembering that the six points available for this indicator will only pay for a couple of minutes of time with a GP for each patient.

Current indicators  

Hypertension (HYP) indicators Points Achievement thresholds

HYP001: The contractor establishes and maintains a register of patients with established hypertension.

6

 

HYP002: The percentage of patients with hypertension in whom the last blood pressure reading (measured in the preceding 9 months) is 150/90mmHg or less.

10 in England & Wales

55 in Scotland & N Ireland

England: 44-84%*

Wales: 45-80%

Scotland: 45-80%

N Ireland: 65-80%

New indicator (England and Wales only)
HYP003:
The percentage of patients aged 79 or under with hypertension in whom the last blood pressure reading (measured in the preceding 9 months) is 140/90mmHg or less.

50 in England

45 in Wales

England: 40-80%

Wales 45-80%

New indicator (England only)
HYP004: The percentage of patients aged 16 or over and who have not attained the age of 75 in whom there is an assessment of physical activity, using GPPAQ, in the preceding 12 months.

5

40-90%

New indicator (England only)
HYP005: The percentage of patients aged 16 or over and who have not attained the age of 75 who score 'less than active' on GPPAQ in the preceding 12 months, who have also recorded a brief intervention in the preceding 12 months.

6

40-90%

*Indicates a change in thresholds for 2013/14

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