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GMS Contract Guide - Hypothyroidism

The hypothyroidism disease area generates £872 in 2007/8 for the practice with average list size and prevalence.

Hypothyroidism: Clinical Indicators
Target (%)Points
Register of patients with hypothyroidismRegister1
Ongoing management
Thyroid function tests recorded in past 15 months906
Total 7



  • Although rewards are smaller, it should be straightforward to earn maximum points.

  • According to the framework data for 2006/7, prevalence was 2.49 per cent in England and 2.87 per cent in Northern Ireland. Data for 2005/6 shows prevalence in Scotland was 3 per cent and prevalence in Wales 2.9 per cent.

  • In England in 2005/6 average exception reporting rates for hypothyroidism were 0.59 per cent.

  • Nothing changed in this disease area under the framework review for 2006/7, except that setting up a register is now worth one point, not two. The minimum threshold also rose from 25 to 40 per cent.

Step 1: Setting up the register

  • The register is of patients taking levothyroxine with a recorded diagnosis of hypothyroidism.

  • Start by searching for all patients who are being prescribed levothyroxine. Then check that all of these patients’ notes record a diagnosis of hypothyroidism and the preferred Read code.

  • Make sure all new patients diagnosed with hypothyroidism are coded with the preferred Read code.

  • Checks should be in place to make sure deceased patients or those who move away are removed from the register.

  • Patients with hypothyroidism who join the practice also need to be entered on the system.

Step 2: From now onwards

  • All patients on the register need thyroid function tests recorded in the past 15 months.

  • Run a report to see how you are performing on this at the beginning of the contract year.

  • Decide on a system to make sure all patients have the relevant tests by April 2008.

  • Make sure you run regular reports to follow up patients who have not undertaken the relevant tests.

  • Measuring performance should be easy because biochemistry results are delivered electronically to most practices.

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