Due to the QOF changes introduced this year, which appeared relatively straightforward but involve substantial behind-the-scenes changes to business rules and register/target patient group definitions, there are currently some anomalies within prevalence reporting for 2026/27:
Heart Failure (HF) with Reduced Ejection Fraction (EF)
In previous years this register largely focused on Heart Failure due to Left Ventricular Systolic Dysfunction (LVSD) and the latest national average prevalence reflects that. However, this year the register now focuses solely on HF with reduced EF and as a result prevalence has decreased for many practices and will likely do the same nationally. As a result, the comparison between the previous national prevalence figures and your own may provide a start contrast.
Example – Large 60k+ patient practice, register this year has dropped by just under 700 patients and £27,900. Also see Pg1 for other examples.
Non-Diabetic Hyperglycaemia (pre pre-diabetes)
The NDH register has had an expansion of its cohort this year to now include patients that have ever had a diagnosis of gestational diabetes. This will inevitably result in an increase to the size of the NDH register, though by how much will vary between each practice. It also means that comparison to the most recent national average, which didn’t include gestational diabetes, will be misleading.
Obesity
After previously having all points removed last year, two new indicators with attached points have been introduced this year. As a result, this historic prevalence figure is likely significantly lower than the true expected prevalence, and obesity rates are likely higher than currently being reported on. It is important to validate your obesity register to ensure eligible patients are appropriately coded and offered suitable weight management interventions and support programmes where clinically indicated.
Prevalence rates are not updated until the end of each QOF year where they are used to calculate your final annual income. As we are very much running with our eyes shut on the above areas, the over-riding message is ensure your prevalence is accurate – if it is accurate you will be delivering high quality patient care and being paid appropriately for the burden of disease on your practice.
For more information on how our QOF Prevalence Health Check can help ensure your registers are validated, or for any general queries on prevalence, please don’t hesitate to contact us.
