Each row tells you the target's code, who's eligible, what counts as complete (including the SNOMED codes where relevant), and how often it fires.
Cadence values: Annual (resets 1 April), Seasonal (per campaign season), One-off (age- or event-triggered), One-off catch-up (time-limited — check for the programme end date), Dose-dependent (fires once the previous dose is due), Event-based (triggered by a specific clinical event, e.g. a diagnosis or result), or Continuous (CQC safety monitoring that re-evaluates each cycle).
What does 💰 mean?
Income-protected indicator: the practice is paid on this indicator regardless of overall achievement, so it's worth prioritising even outside a wider campaign push.
What does 🎯 mean?
Treat to target indicator: they have a defined measurement target (e.g. blood pressure or HbA1c) that the patient must meet. If the latest reading on the patient's record does not meet the target, or if no reading is recorded at all, the patient will continue to be recalled until the target is achieved and recorded.
What does 🍂 mean?
Seasonal indicator: these are included below even if they're currently switched off — they'll are kept here for reference but may not appear on the platform until they are in season.
🎯All Targets/Indicators
💨 Asthma [QOF]
💨 Asthma [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
AST007 | Annual asthma review | Patients aged 5+ on the asthma register with no qualifying annual review in the last 12 months | Asthma review in the last 12 months with a written personalised action plan on the same day and an exacerbation count recorded within 1 month before the review | Annual |
AST008 💰 | Smoking status (young asthmatics) | Asthma patients aged ≤19, no smoking status in last 12m | Personal smoking status, second-hand smoke exposure, or no second-hand smoke exposure recorded in the last 12 months. | Annual |
AST014 | Objective testing for new diagnoses | Patients diagnosed with asthma on or after 1 April 2025, without objective test evidence recorded within 3 months before/after diagnosis | Age-appropriate objective test recorded in that window — adults (17+): FBC, FeNO, spirometry, peak-flow variability (if spirometry unavailable), or bronchial challenge; children (5–16): FeNO, spirometry, peak-flow variability, skin-prick test, IgE + FBC together, or bronchial challenge | Event-based (per diagnosis) |
AST015 | Annual asthma review (v51) | Patients aged 5+ on the asthma register with no qualifying annual review in the last 12 months | Asthma review in the last 12 months with a written personalised action plan on the same day and an exacerbation count recorded within 1 month before the review | Annual |
🎗️ Cancer (Preventative Health Screenings)
🎗️ Cancer (Preventative Health Screenings)
Code | Name | Who & when to recall | What counts as complete | Cadence |
HIGHRISK_UPPERGI | High-risk upper GI cancer screening | Patients aged ≥50 in the upper-GI screening population (GORD/acid suppression, ≥3 PPI/H2RA courses, hiatus hernia, etc.; excludes palliative care, upper-GI cancer, Barrett's, severe frailty) with ≥1 high-risk factor: obese BMI, current/ex-smoker, or family history of oesophageal cancer; not yet assessed. | Screening for oesophageal malignancy recorded, or patient coded not contactable. | Event-based |
NONHIGHRISK_UPPERGI | Non-high-risk upper GI cancer screening | Same UPPERGI_POP (aged ≥50) patients without those high-risk factors; not yet assessed. | Screening for oesophageal malignancy recorded, or patient coded not contactable. | Event-based |
PANCAN_SG1 | Pancreatic cancer case finding, weight loss group | Patients aged 60+ at date of new-onset diabetes (NOD) diagnosis, with unexplained weight loss | Pancreatic cancer risk assessment, suspected-cancer code, or 'not contactable' code (on/after 1 Dec 2025) recorded | Event-based |
PANCAN_SG2 | Pancreatic cancer case finding — no weight loss recorded | Patients aged 60+, newly diagnosed with NOD, no unexplained weight loss recorded | Pancreatic cancer risk assessment, suspected-cancer code, 'not contactable' code, or weight-declined code (on/after 1 Dec 2025) recorded | Event-based |
PCHR001 | Prostate cancer screening invitation. | Men aged 45–70; men aged 45–49 only if Black/Caribbean ethnicity or family history of prostate cancer. Excludes screening objections, declines, palliative care, and recent registration (within 3 months). | Screening invitation recorded | Event-based |
❤️ Cardiovascular - General
❤️ Cardiovascular - General
Code | Name | Who & when to recall | What counts as complete | Cadence |
CD001 🎯 | BP control, CHD/stroke/TIA, aged ≤79 | CHD, stroke or TIA patients aged 79 or under, without moderate/severe frailty, with BP ≤140/90. | a BP within range is recorded | Annual |
CD002 🎯 | BP control, CHD/stroke/TIA, aged ≥80 | CHD, stroke or TIA patients aged 80 or over, without moderate/severe frailty, with BP ≤150/90. | a BP within range is recorded | Annual |
❤️ Cardiovascular – AF Atrial Fibrillation [QOF]
❤️ Cardiovascular – AF Atrial Fibrillation [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
AF006 | Stroke risk assessment | AF patients with no CHA₂DS₂-VASc score in the last 12m | CHA₂DS₂-VASc score recorded | Annual |
AF008 | Anticoagulants for high-risk AF | AF patients with CHA₂DS₂-VASc ≥2 and no anticoagulant prescribed | Anticoagulant (DOAC or warfarin) prescription recorded | One-off (until prescribed) |
❤️ Cardiovascular – CHD Coronary Heart Disease [QOF]
❤️ Cardiovascular – CHD Coronary Heart Disease [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
CHD005 | Antiplatelets or anticoagulants | Patients on the CHD register with no antiplatelet / anticoagulant prescribed | Aspirin, clopidogrel, or anticoagulant prescription recorded | One-off (until prescribed) |
CHD015 🎯 | BP control (age ≤79) | CHD patients aged 79 or under, no BP ≤140/90 in last 12m | BP ≤140/90 mmHg recorded | Annual |
CHD016 🎯 | BP control (age 80+) | CHD patients aged 80+, no BP ≤150/90 in last 12m | BP ≤150/90 mmHg recorded | Annual |
❤️ Cardiovascular – HF Heart Failure [QOF]
❤️ Cardiovascular – HF Heart Failure [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
HF003 | ACE-I or ARB for LVSD | Patients with HF due to LVSD, no ACE-I or ARB prescribed | ACE-I or ARB prescription recorded | One-off (until prescribed) |
HF006 | Beta-blocker for LVSD | Patients with HF due to LVSD, no licensed beta-blocker prescribed | Licensed beta-blocker (e.g. bisoprolol, carvedilol) prescription recorded | One-off (until prescribed) |
HF007 | Annual HF review | Patients on the HF register, no review in last 12m | HF review and medication review (HF-specific or generic med review) both recorded in the last 12 months. | Annual |
HF008 | HF diagnosis confirmation | Patients with a new HF diagnosis on or after 1 April 2023 with no echo or specialist assessment recorded in the 6m before the diagnosis (or, if registered after diagnosis, no echo/specialist assessment within 6m of registration) | Echocardiogram or specialist assessment recorded | Event-based (per diagnosis) |
HF009 🍂 this campaign should not start until October -there is no payment benefit before this point | Four-pillar therapy, HFrEF | HF patients with reduced ejection fraction not yet on all four pillars of therapy (ACE-I/ARB/ARNI, beta-blocker, MRA, SGLT-2 inhibitor) | On quadruple therapy: ACE-I or ARB or ARNI + licensed beta-blocker + MRA + SGLT2 inhibitor, each issued within the last 6 months. | One-off (until prescribed), re-evaluates until all four pillars are met. |
❤️ Cardiovascular – Hypertension [QOF]
❤️ Cardiovascular – Hypertension [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
BP002 | BP check (age ≥45) | Patients aged 45+ with no BP recorded in last 5 years | Blood pressure recorded | Every 5 years |
HYP008 🎯 | BP control – hypertension (age ≤79) | Hypertensive patients aged ≤79, no BP ≤140/90 (clinic) or ≤135/85 (HBPM) in last 12m | BP at target recorded | Annual |
HYP009 🎯 | BP control – hypertension (age 80+) | Hypertensive patients aged 80+, no BP ≤150/90 (clinic) or ≤145/85 (HBPM) in last 12m | BP at target recorded | Annual |
HYP010 🎯 | BP control – hypertension, no frailty (age ≤79) | Hypertensive patients aged ≤79, without moderate or severe frailty, no BP ≤140/90 recorded | BP ≤140/90 mmHg recorded | Annual |
HYP011 🎯 | BP control – hypertension, no frailty (age 80+) | Hypertensive patients aged 80+, without moderate or severe frailty, no BP ≤150/90 recorded | BP ≤150/90 mmHg recorded | Annual |
❤️ Cardiovascular – Stroke / TIA [QOF]
❤️ Cardiovascular – Stroke / TIA [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
STIA007 | Antiplatelets or anticoagulants | Stroke/TIA patients with no antiplatelet / anticoagulant prescribed | Aspirin, clopidogrel, dipyridamole, ticagrelor, or anticoagulant prescription recorded | One-off (until prescribed) |
STIA014 🎯 | BP control (age ≤79) | Stroke/TIA patients aged ≤79, no BP ≤140/90 in last 12m | BP ≤140/90 mmHg recorded | Annual |
STIA015 🎯 | BP control (age 80+) | Stroke/TIA patients aged 80+, no BP ≤150/90 in last 12m | BP ≤150/90 mmHg recorded | Annual |
🧫 Cervical Smears [QOF]
🧫 Cervical Smears [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
CS005 | Cervical screening (ages 25–49) | Women aged 25–49 with no smear recorded in last 3 years | Cervical screening recorded within the last 3y6m | Every 3y6m |
CS006 | Cervical screening (ages 50–64) | Women aged 50–64 with no smear recorded in last 5 years | Cervical screening recorded within the last 5y6m | Every 5y6m |
👶 Childhood Immunisations [QOF + Local]
👶 Childhood Immunisations [QOF + Local]
This area has two parallel sets of childhood immunisation indicators — both are selectable in the app, and the same child will often appear in both. They exist for different reasons:
VI001 / VI002 / VI003 — the QOF national indicators. These follow the official QOF Vaccinations & Immunisations rules and check coverage at three milestones: DTP/Polio by 8 months (VI001), 1st MMR by 18 months (VI002), and the pre-school MMR2 + DTaP/IPV booster by age 5 (VI003). They include QOF's contraindication / consent codes and use QOF's cohort definitions. Pick these if your goal is QOF coverage tracking or a catch-up sweep against the QOF milestones.
HIPPO_8WEEK_IMMS / 12WEEK_IMMS / 16WEEK_IMMS / 1Y_IMMS / PRIMARY_IMMS / 18M_MMR / RUNOFF_3Y4M_MMRandDTaP — Hippo's per-visit indicators. These mirror the routine NHS childhood immunisation schedule, with a separate indicator for each visit (8 weeks, 12 weeks, 16 weeks, 1 year, 18 months, 3y4m pre-school). Where QOF only checks coverage at milestones, these surface a child at every stage of the routine schedule. Pick these if you're running proactive recalls along the NHS routine schedule.
How they overlap. A child due their 1st MMR around 18 months would appear in both 18M_MMR (Hippo) and VI002 (QOF). If a campaign includes both, they're treated as one child with one outstanding need — they won't get two invites. The difference is operational: QOF indicators help you measure and catch up against the QOF year; Hippo indicators help you run the schedule month by month.
Code | Name | Who & when to recall | What counts as complete | Cadence |
VI001 | QOF DTaP – 8-month check | Children aged 8–20 months on search date, no DTaP3 recorded by 248 days, not registered too late | 3rd DTaP dose recorded before 248 days of age | One-off (age trigger) |
VI002 | QOF MMR – 18-month check | Children crossing 18 months, no MMR1 recorded by 558 days | 1st MMR dose recorded before 558 days of age | One-off (age trigger) |
VI003 | QOF Five-year booster check | Children aged 5, missing 2nd MMR and/or DTaP/IPV booster | Both 2nd MMR and DTaP/IPV booster recorded before age 5 | One-off (age trigger) |
8WEEK_IMMS | 8-week immunisations | Children aged 8–12 weeks (registered) | 1st DTaP, 1st MenB, 1st Rotavirus all recorded (or coded exclusion) | One-off (age trigger) |
12WEEK_IMMS | 12-week immunisations | Children aged 12–16 weeks | 12-week schedule complete | One-off (age trigger) |
16WEEK_IMMS | 16-week immunisations | Children aged 16–20 weeks | 16-week schedule complete | One-off (age trigger) |
1Y_IMMS | 1-year boosters | Children aged 1–2 | 1st MMR, MenB booster, PCV booster recorded | One-off (age trigger) |
1Y_IMMS_CATCHUP | 1-year catch-up | Children aged 2–9 with incomplete 1-year imms | Outstanding 1-year imms recorded | One-off catch-up |
PRIMARY_IMMS | Primary imms | Children >20 weeks and <2 years | Full primary schedule recorded | One-off (age trigger) |
PRIMARY_IMMS_CATCHUP | Primary imms catch-up | Older children with incomplete primary imms | Outstanding primary imms recorded | One-off catch-up |
18M_MMR | 18-month MMR (2nd dose) | Children >18 months, born on/after 01/07/2024 | 2nd MMR dose recorded | One-off (age trigger) |
MMR_BROUGHTFORWARD | MMR brought-forward campaign | Children turning 1y6m–2y6m on 01/01/2026 (DOB 01/07/2023–01/07/2024). Invites stop 31 Oct 2026. | 2nd MMR dose recorded | One-off catch-up |
3Y4M_OLDSCHEDULE_CATCHUP | Old-schedule catch-up (ages 6–10) | Children aged 6–9 missing MMR2 and/or DTaP/IPV booster | 2 MMR doses + DTaP/IPV booster recorded before age 10 | One-off catch-up |
RUNOFF_3Y4M_MMRandDTaP | Legacy run-off cohort | Closing out the old 3y4m cohort | 2 MMR + DTaP/IPV booster recorded | One-off catch-up |
🧬 Cholesterol [QOF]
🧬 Cholesterol [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
CHOL003 🍂 this campaign should not start until October -there is no payment benefit before this point | Statin prescription | Patients on the CHD, PAD, stroke/TIA, or CKD stage 3+ register (age 18+ for CKD), excluding those also on the unresolved diabetes register (they're handled by DM034/DM035 instead), with no statin prescribed | Statin (e.g. atorvastatin) prescription recorded | One-off (until prescribed) |
CHOL004 🎯 | Cholesterol control | Patients on the CHD, PAD, or stroke/TIA register (excludes haemorrhagic stroke) with no cholesterol test in the last 12 months, or with a result above target (LDL ≤2.0 mmol/L, or non-HDL ≤2.6 mmol/L if LDL not available) | Cholesterol test recorded with result within target range | Annual
|
🫁 COPD [QOF]
🫁 COPD [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
COPD010 | COPD annual review | Patients on the COPD register, no review in last 12m | COPD review, exacerbation count, and MRC scale all recorded in the last 12 months. | Annual |
COPD014 💰 | Pulmonary rehab offer | COPD patients with MRC score ≥3, not previously offered rehab | Offer of referral to pulmonary rehab recorded | One-off (per MRC trigger) |
HLTC_COPD_RVW | COPD annual review (NICE) | Patients on the COPD register with no COPD-specific or general LTC review recorded this financial year | Review incl. MRC scale, medication check, inhaler technique, smoking support if needed | Annual |
🦠 COVID [Vaccinations]
🦠 COVID [Vaccinations]
Code | Name | Who & when to recall | What counts as complete | Cadence |
COVID_SPRING25_001 🍂 | Spring booster – aged 75+ | Patients aged 75+ at the gov reference date (17 June) with no booster recorded in the last 3 months | COVID vaccine recorded in the 3 months prior to spring PPED | Seasonal (spring) |
COVID_SPRING25_002 🍂 | Spring booster – care home residents | Patients <75 at the gov reference date who are care-home residents | COVID vaccine recorded in the 3 months prior to spring PPED | Seasonal (spring) |
COVID_SPRING25_003 🍂 | Spring booster – immunocompromised | Patients <75 with persistent immunocompromise, on immunosuppressive drugs, or with a temporary immunocompromise code in the last 9 months | COVID vaccine recorded in the 3 months prior to spring PPED | Seasonal (spring) |
COVID_WINTER_ENHANCED_001 🍂 | Winter booster – aged 75+ | Patients aged 75+ at PPED (31/01/2026) with no booster recorded in the last 4 months | COVID vaccine recorded in the 4 months prior to winter PPED | Seasonal (autumn/winter) |
COVID_WINTER_ENHANCED_003 🍂 | Winter booster – immunocompromised | Patients <75 at PPED who are immunocompromised per Green Book 25/26: persistent immunosuppression (and not since resolved), immunodeficiency, solid organ transplant, immunosuppressive drugs in last 12m, or chemo/radiotherapy in last 6m | COVID vaccine recorded in the 4 months prior to winter PPED (31/01/2026) | Seasonal (autumn/winter) |
🧪 CQC Quality Monitoring – DMARDs [CQC]
🧪 CQC Quality Monitoring – DMARDs [CQC]
All three DMARD indicators share the same shape: patients issued the drug in the last 6 months should have a defined panel of bloods within the last 12 weeks. The panels differ slightly — leflunomide adds BP and weight to the standard FBC/U&Es/LFTs.
Code | Name | Who & when to recall | What counts as complete | Cadence |
CQCAZA001 | Azathioprine monitoring | Patients issued azathioprine in last 6m | FBC + U&Es + LFTs all recorded in last 12 weeks | Continuous |
CQCLEF001 | Leflunomide monitoring | Patients issued leflunomide in last 6m | FBC + U&Es + LFTs + BP + weight all recorded in last 12 weeks | Continuous |
CQCMET001 | Methotrexate monitoring | Patients issued methotrexate in last 6m | FBC + U&Es + LFTs all recorded in last 12 weeks | Continuous |
💊 CQC Quality Monitoring – DOAC Anticoagulants [CQC]
💊 CQC Quality Monitoring – DOAC Anticoagulants [CQC]
The DOAC family stacks two dimensions: the number sets the time window and patient sub-cohort; the suffix sets which kidney measurement is checked (A = serum creatinine, B = CrCl calculated where weight + serum creatinine are up-to-date). Practices select whichever variant matches the data their team actually records.
Code | Name | Who & when to recall | What counts as complete | Cadence |
CQCDOAC000 | DOAC – weight recorded | All patients on a DOAC | Weight recorded in last 12m | Continuous |
CQCDOAC001A | DOAC – serum creatinine ever recorded | All patients on a DOAC | Serum creatinine recorded at least once | Continuous |
CQCDOAC001B | DOAC – CrCl calculable, ever | DOAC patients with weight (last 12m) + serum creatinine | Creatinine clearance recorded at least once | Continuous |
CQCDOAC002A | DOAC – serum creatinine in last 12m | All patients on a DOAC | Serum creatinine recorded in last 12m | Continuous |
CQCDOAC002B | DOAC – CrCl calculable in last 12m | DOAC patients with weight + serum creatinine in last 12m | Creatinine clearance recorded in last 12m | Continuous |
CQCDOAC003A | DOAC + CKD4/5 – serum creatinine in last 3m | DOAC patients with current CKD4/5 | Serum creatinine recorded in last 3m | Continuous |
CQCDOAC003B | DOAC + CKD4/5 – CrCl calculable in last 3m | DOAC + CKD4/5 patients with weight (12m) + serum creatinine (3m) | Creatinine clearance recorded in last 3m | Continuous |
CQCDOAC004A | DOAC + CKD3 – serum creatinine in last 6m | DOAC patients with current CKD3 | Serum creatinine recorded in last 6m | Continuous |
CQCDOAC004B | DOAC + CKD3 – CrCl calculable in last 6m | DOAC + CKD3 patients with weight (12m) + serum creatinine (6m) | Creatinine clearance recorded in last 6m | Continuous |
CQCDOAC006 | DOAC – low-Hb anticoag review | DOAC patients whose last Hb was <90 | Anticoagulation review recorded after the low-Hb result | Event-based (per low Hb) |
CQCDOAC007 | DOAC – appropriate kidney function | All patients on a DOAC | CrCl ≥30 if on dabigatran; CrCl ≥15 otherwise | Continuous |
📋 CQC Quality Monitoring – Missed Diagnoses [CQC]
📋 CQC Quality Monitoring – Missed Diagnoses [CQC]
Code | Name | Who & when to recall | What counts as complete | Cadence |
CQC_MISDIAG_CKD | Missed CKD diagnosis | Patients with most recent eGFR <60 plus a 2nd low eGFR in last 2 years, no CKD diagnosis coded | CKD-resolved code, CKD 1–2 code, or CKD 3–5 diagnosis recorded after the diagnostic result | Continuous |
CQC_MISDIAG_DM | Missed diabetes diagnosis | Patients with two HbA1c results ≥48 mmol/mol in last 2 years, no diabetes diagnosis coded | DM-resolved, prediabetes (after the diagnostic result), gestational/steroid-induced DM (last 12m), haemoglobinopathy, or current DM diagnosis recorded | Continuous |
💊 CQC Quality Monitoring – Other Meds Monitoring [CQC]
💊 CQC Quality Monitoring – Other Meds Monitoring [CQC]
Code | Name | Who & when to recall | What counts as complete | Cadence |
CQCWARFARIN001 | Warfarin – INR monitoring | All patients on warfarin | INR recorded in last 3m, or patient flagged as INR self-monitor in last 12m | Continuous |
CQCWARFARIN002 | Warfarin – high INR review | Warfarin patients with one INR >8 in last 6m, or two INR >5 in last 6m | Anticoagulation review recorded after the triggering high INR | Event-based (per high INR) |
CQCACEARB001 | ACE-I / ARB – kidney function | All patients on ACE-I or ARB | U&Es (creatinine or eGFR) recorded in last 12m | Continuous |
CQC_HYPO | Hypothyroidism: TSH monitoring | Patients issued thyroid replacement therapy in the last 12 months without a TSH in the last 12 months. | TSH result recorded in the last 12 months. | Continuous |
CQCLI001 | Lithium – level monitoring | All patients on lithium | Lithium level recorded in last 3m | Continuous |
CQCLI002 | Lithium – calcium / kidney / thyroid | All patients on lithium | U&Es + calcium + thyroid function all recorded in last 6m | Continuous |
CQCMETFORMIN001 | Metformin – kidney function | All patients on metformin | eGFR recorded in last 12m | Continuous |
CQCMETFORMIN002 | Metformin – satisfactory kidney function | Metformin patients with an eGFR in last 12m | Most recent eGFR ≥30 | Continuous |
CQCALDANT001 | Aldosterone antagonist + HF – kidney function | Patients on spironolactone/eplerenone with current HF (not resolved) | U&Es recorded in last 6m | Continuous |
CQCAMIODERONE001 | Amiodarone – kidney / liver / thyroid | All patients on amiodarone | U&Es + LFTs + TFTs all recorded in last 6m | Continuous |
🚨 CQC Quality Monitoring – Safety Alerts [CQC]
🚨 CQC Quality Monitoring – Safety Alerts [CQC]
MHRA-driven safety alerts. Each indicator targets a specific drug-pair / drug-cohort combination flagged for adverse-event monitoring.
Code | Name | Who & when to recall | What counts as complete | Cadence |
CQCSAFETYALERT001 | Hydrochlorothiazide – skin cancer info | Patients prescribed hydrochlorothiazide in last 6m | Skin cancer risk information recorded after first HCTZ issue | Continuous |
CQCSAFETYALERT002 | High-dose SSRI in 65+ | Patients aged 65+ issued high-dose SSRI (citalopram 40mg or escitalopram 20mg) in last 3m | Medication review in last 3m | Continuous |
CQCSAFETYALERT003 | Clopidogrel + PPI interaction | Patients issued clopidogrel and omeprazole/esomeprazole in last 3m | Medication review in last 3m | Continuous |
CQCSAFETYALERT004 | Febuxostat with CVD | Patients issued febuxostat in last 3m and with PAD/CHD/stroke/TIA | Medication review in last 3m | Continuous |
CQCSAFETYALERT005 | Fentanyl patch started without prior opioid | Patients started on fentanyl patch in last 12m, no other opioid in the 3m before | Medication review since starting the fentanyl patch | Event-based (per new start) |
CQCSAFETYALERT006 | Mirabegron – BP monitoring | Patients issued mirabegron in last 3m | BP recorded in last 12m | Continuous |
CQCSAFETYALERT008 | SGLT-2i – ketoacidosis & Fournier's education | Patients issued an SGLT-2 inhibitor in last 6m | Ketoacidosis education and Fournier's gangrene education recorded after SGLT-2i start | Continuous |
CQCSAFETYALERT009 | Simvastatin 40/80mg + CYP3A4 CCB | Patients issued simvastatin 40/80mg and amlodipine/diltiazem/verapamil in last 3m | Medication review in last 3m | Continuous |
CQCSAFETYALERT010 | Teratogenic drugs in women of childbearing potential | Female patients aged 8–<55 issued teratogenic drugs in last 3m, no confirmed infertility | Medication review in last 3m | Continuous |
🧠 Dementia [QOF]
🧠 Dementia [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
DEM004 | Face-to-face dementia review | Patients with dementia and no care plan review in last 12m | Face-to-face care plan review covering physical, mental, social needs | Annual |
💉 Diabetes - [QOF]
💉 Diabetes - [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
DM006 | ACE-I/ARB for microalbuminuric diabetics | Diabetics with microalbuminuria/proteinuria, no ACE-I/ARB prescribed | ACE-I or ARB prescription recorded | One-off (until prescribed) |
DM012 | Foot examination | Diabetics with no foot check in last 12m | Foot exam with risk classification recorded | Annual |
DM014 | Diabetes education referral | Newly diagnosed diabetics with no referral to structured education | Referral to structured education recorded | One-off (per diagnosis) |
DM020 🎯 | HbA1c control (non-frail) | Non-frail diabetics with HbA1c >58 mmol/mol in last 12m | HbA1c ≤58 mmol/mol recorded | Annual |
DM021 🎯 | HbA1c control (frail) | Frail diabetics with HbA1c >75 mmol/mol | HbA1c ≤75 mmol/mol recorded | Annual |
DM034 | Statins for diabetics (no CVD, no frailty) | Diabetics aged ≥40 with no CVD, no moderate/severe frailty, not on a statin (excludes type 2 with CVD risk <10% in last 3 years) | Statin prescription recorded (or alternative lipid-lowering therapy if statin declined/clinically unsuitable) | One-off (until prescribed) |
DM035 | Statins for diabetics with CVD | Diabetics with CVD (excluding haemorrhagic stroke) and no statin | Statin prescription recorded (or alternative lipid-lowering therapy if statin declined/clinically unsuitable) | One-off (until prescribed) |
DM036 🎯 | BP control – diabetes (age ≤79, non-frail) | Diabetics aged ≤79 without moderate/severe frailty, no BP ≤140/90 in last 12m | BP ≤140/90 mmHg recorded (clinic) — equivalent HBPM target 135/85 | Annual |
DM037 | Diabetes 8 care processes (combined) | Diabetics missing one or more of the 8 care processes (BMI, BP, HbA1c, cholesterol, smoking status, foot check, eGFR, urine ACR) | Relevant care recorded as above | Annual/One-off |
🩸 Diabetes - 8 Care Processes [Local]
🩸 Diabetes - 8 Care Processes [Local]
All follow the same logic: patient is on the diabetes register and missing the result in the last 12 months.
Code | Name | Who & when to recall | What counts as complete | Cadence |
HIPPODM8CP001a | HbA1c | Diabetics with no HbA1c in last 12m | HbA1c result recorded | Annual |
HIPPODM8CP001b | Blood Pressure | Diabetics with no BP in last 12m | BP recorded | Annual |
HIPPODM8CP001c | Cholesterol | Diabetics with no serum cholesterol in last 12m | Cholesterol result recorded | Annual |
HIPPODM8CP001d | Creatinine | Diabetics with no creatinine in last 12m | Creatinine result recorded | Annual |
HIPPODM8CP001e | Urine ACR | Diabetics with no albumin:creatinine ratio in last 12m | ACR result recorded | Annual |
HIPPODM8CP001f | Foot Check | Diabetics with no foot check or risk score in last 12m | Foot check + risk score recorded | Annual |
HIPPODM8CP001g | BMI | Diabetics with no BMI in last 12m | BMI recorded | Annual |
HIPPODM8CP001h | Smoking Status | Diabetics with no smoking status in last 12m | Smoking status recorded | Annual |
🩺 FIT Safety Netting [Local]
🩺 FIT Safety Netting [Local]
Code | Name | Who & when to recall | What counts as complete | Cadence |
HIPPOFIT001 | Patients with FIT results outstanding | Patients provisioned a FIT test with no result recorded yet | FIT result recorded after kit provision accepted. | Event-based (7 days after provision) |
HIPPOFIT002 | Patients with failed FIT outcomes | Patients with an accepted, non-declined FIT provision who don't yet have a failed FIT outcome recorded | Failed FIT outcome code recorded post-provision. | Event-based |
HIPPOFIT003 | FIT provisioned code review | Patients who should have had a FIT-provisioned code recorded but didn't | FIT provision code recorded where a result exists but provision is missing. | Event-based |
HIPPOFIT004 | Post-FIT safety netting survey | Patients whose FIT safety-netting pathway has started | Survey sent/recorded | Event-based (~21 days after pathway start) |
💉 Flu [Vaccinations]
💉 Flu [Vaccinations]
This area has two parallel sets of indicators because they answer different questions.
*SFVI* ("Flu jab — …") — sourced from the QOF/IIF Enhanced Service business rules. These measure raw coverage: did the patient get vaccinated? They keep flagging a patient even if they've declined, have a clinical contraindication, or have already been invited twice with no response. Use these if you want headline coverage figures that mirror the QOF/IIF target.
*VI*W25 ("Enhanced winter flu vaccine — …") — Hippo's operational recall rules, aligned to the Ardens Winter 2025 searches. These respect patient choice and clinical context: a patient is excluded once they've declined, been coded with a contraindication, or failed to respond to ≥2 invitations 7 days apart. Use these when you want a recall list that won't keep chasing patients who've already said no or shouldn't be vaccinated.
The at-risk cohort definition (the 18–64 indicators) also differs slightly: SFVI002 includes pregnancy and Addison's; VI02W25 instead includes carer status, "lives with immunocompromised", endocrine disease, splenic dysfunction, and care-home residency.
Code | Name | Who & when to recall | What counts as complete | Cadence |
SFVI001 🍂 | Flu jab – >65s | Patients aged 65+ at flu QSED with no flu vaccine this season | Flu vaccine recorded for the current season | Seasonal (annual) |
SFVI002 🍂 | Flu jab – at-risk patients | Patients aged 18–64 with at-risk codes (chronic resp/heart/liver/neurological disease, asthma on treatment, CKD3+, diabetes, immunosuppression, BMI ≥40, pregnancy, LD, Addison's), no flu vaccine this season | Flu vaccine recorded this season | Seasonal (annual) |
SFVI003 🍂 | Flu jab – 2–3s | Children aged 2 or 3 on 31 Aug, no flu vaccine recorded this season (legacy 2022 rule, retained) | Flu vaccine recorded (usually nasal spray) | Seasonal (annual) |
VI01W25 🍂 | Enhanced winter flu vaccine – >65s | Patients aged 65+ at QSED, no flu vaccine this season; excludes contraindications, declines, and patients invited ≥2 times 7 days apart | Flu vaccine recorded between 1 Oct and 31 Mar | Seasonal (annual) |
VI02W25 🍂 | Enhanced winter flu vaccine – 18–64 at-risk | Patients 18–64 with at-risk codes (chronic resp/heart/liver/neuro disease, asthma on treatment, CKD3+, diabetes, immunosuppression, BMI ≥40, LD, asplenia, care home, carer, lives with immunocompromised, "needs flu imm this season"), no flu vaccine this season; excludes contraindications, declines, and 2-invite no-response | Flu vaccine recorded between 1 Oct and 31 Mar | Seasonal (annual) |
VI03W25 🍂 | Enhanced winter flu vaccine – children | Children aged ≥2 and <4 the day before flu service start, no flu vaccine this season; excludes contraindications, declines, and 2-invite no-response | Flu vaccine recorded (usually nasal spray) | Seasonal (annual) |
💉 HPV Catch-Up [Vaccinations]
💉 HPV Catch-Up [Vaccinations]
Code | Name | Who & when to recall | What counts as complete | Cadence |
HPV_18TO24_CATCHUP | HPV catch-up (ages 18–24) | Females aged 18–24. Males aged 18–24 born on/after 01/09/2006. | HPV vaccination recorded | One-off catch-up |
🧠 Learning Disabilities [DES]
🧠 Learning Disabilities [DES]
Code | Name | Who & when to recall | What counts as complete | Cadence |
HI-03 | Annual health check (LD), aged 14+ | LD patients aged ≥14 on the LD register with no health check and action plan recorded in the current year | Health check completed and recorded, including an action plan and an ethnicity code on file | Annual |
🫀 Long-Term Conditions (LTCs)
🫀 Long-Term Conditions (LTCs)
Structured-review indicators per disease register, fired alongside the disease-specific QOF entries to coordinate combined reviews.
✅ Generic Annual Review Codes
These codes will complete care across all LTC indicators if entered:
525711000000101 – General practice annual review completed
170557005 – Annual review (generic)
⚠️ Use with caution: if you use these generic codes, Hippo will assume care is complete for all LTCs, not just one condition.
Code | Name | Who & when to recall | What counts as complete |
HLTC_AF_RVW | AF patients receiving annual review | Patients on the AF register (AFIBLAT, not resolved), no review or general LTC review recorded this FY | Annual review recorded — accepted SNOMED codes: |
HLTC_AST_RVW | Asthma patients receiving annual review | Patients on the asthma register, no asthma or general LTC review recorded this FY | Annual review recorded — accepted SNOMED codes: |
HLTC_CARDIO_NO_DM_RVW | CVD patients without diabetes, reviewed | Patients in HLTC_CARDIO_RVW but not in HLTC_DM_RVW | Must also be in the numerator for the CVD review indicator |
HLTC_CHD_RVW | CHD patients receiving annual review | Patients on the CHD register, no CHD or general LTC review recorded this FY | Annual review recorded — accepted SNOMED code: |
HLTC_COPD_RVW | COPD patients receiving annual review | Patients on the COPD register, no COPD or general LTC review recorded this FY | Annual review recorded — accepted SNOMED code: |
HLTC_DM_RVW | Diabetes patients receiving annual review | Patients on the diabetes register, no diabetes or general LTC review recorded this FY | Annual review recorded — accepted SNOMED codes: |
HLTC_HF_RVW | Heart failure patients receiving review | Patients on the HF register, no HF or general LTC review recorded this FY | Annual review recorded — accepted SNOMED codes: |
HLTC_HYP_RVW | Hypertension patients receiving review | Patients on the hypertension register, no hypertension or general LTC review recorded this FY | Annual review recorded — accepted SNOMED code: |
HLTC_MH_RVW | Mental health patients reviewed | Patients on the SMI register, no MH or general LTC review recorded this FY | Annual review recorded — accepted SNOMED codes: |
HLTC_NDH_RVW | NDH patients reviewed | Adults on the NDH (pre-diabetes) register, no NDH or general LTC review recorded this FY. Excludes patients with current diabetes diagnosis. | Recent HbA1c or fasting glucose result counts — accepted SNOMED codes: |
HLTC_PAD_RVW | PAD patients receiving review | Patients with PAD diagnosis (not excluded), no PAD or general LTC review recorded this FY | Annual review or recent lipid result counts — accepted SNOMED codes: |
HLTC_STIA_RVW | Stroke/TIA patients receiving review | Patients on the stroke/TIA register, no STIA or general LTC review recorded this FY | Annual review recorded — accepted SNOMED code: |
🧠 Mental Health [QOF]
🧠 Mental Health [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
MH002 | Care plan review | Patients with psychosis/bipolar and no care plan in last 12m | Care plan review covering physical and mental health needs | Annual |
MH003 | Blood Pressure | SMI patients with no BP in last 12m | BP recorded | Annual |
MH006 | BMI | SMI patients with no BMI in last 12m | BMI recorded | Annual |
MH007 | Alcohol | SMI patients with no alcohol use recorded in last 12m | Alcohol use recorded | Annual |
MH011 | Lipids | Patients on the mental health register without a lipid profile in the last 12 months (high-risk group: on antipsychotics, or with CHD/stroke/TIA/PAD/CKD3+/FH hypertension/DM, current smoker, or BMI ≥23 Asian / ≥25 other" with "BMI ≥23 for non-White ethnicity (incl. unrecorded ethnicity) / ≥25 for White ethnicity or last 24 months (lower-risk group: none of the above). | Lipid profile recorded | Annual (high-risk group) / Every 2 years (lower-risk group) |
MH012 | HbA1c | SMI patients with no HbA1c in last 12m | HbA1c or blood glucose result recorded | Annual |
MH021 💰 | SMI annual health check (all 6) | SMI patients missing ≥1 of: BP, BMI, alcohol, smoking, lipids, HbA1c | All 6 checks completed and recorded in last 12m | Annual |
🩺 NHS Health Checks [Local]
🩺 NHS Health Checks [Local]
Code | Name | Who & when to recall | What counts as complete | Cadence |
HIPPONHSHC001 | Overall coverage | Patients aged 40–74 with no NHS HC in last 5 years, not already on the CHD/CKD/diabetes/hypertension/AF/stroke-TIA registers, without familial hypercholesterolaemia/HF/PAD, without a statin issued or a CVD risk score >20 in the last 12 months, and not already mid-check | NHS Health Check 'complete' code recorded | Every 5 years |
HIPPONHSHC002 | Current-year invite | Patients eligible this year, no check recorded yet | NHS HC recorded during the current financial year | Per FY |
HIPPONHSHC002a | BP (NHS HC) | NHS HC patients this year with no BP recorded | BP reading recorded | Per FY |
HIPPONHSHC002b | BMI (NHS HC) | NHS HC patients with no BMI recorded | BMI recorded | Per FY |
HIPPONHSHC002c | Cholesterol (NHS HC) | NHS HC patients with no total cholesterol recorded | Cholesterol result recorded | Per FY |
HIPPONHSHC002d | HbA1c (NHS HC) | NHS HC patients with no HbA1c recorded | HbA1c result recorded | Per FY |
HIPPONHSHC002e | All components completed | NHS HC patients who have had BP, BMI, cholesterol, and HbA1c all recorded in the last 12 months, but with no formal NHS HC event code yet | Formal NHS HC event code recorded | Per FY |
💉 Pneumococcal [Vaccinations]
💉 Pneumococcal [Vaccinations]
Code | Name | Who & when to recall | What counts as complete | Cadence |
HIPPOPNEU001A/B | Lifetime pneumo vaccine (age 65+) | Patients aged 65+ with no PPV23 ever recorded | Pneumococcal vaccine (PPV23) recorded | One-off (age trigger) |
HIPPOPNEU002A/B | First pneumo vaccine (at-risk <65) | Patients aged 2–64 with LTCs and no PPV23 recorded | Pneumococcal vaccine recorded | One-off (until vaccinated) |
🧪 Pre-diabetes [QOF]
🧪 Pre-diabetes [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
NDH002 | Blood glucose monitoring | Patients aged 18+ on the non-diabetic hyperglycaemia (NDH) register with no HbA1c or fasting plasma glucose recorded in the last 12 months | HbA1c or FPG result recorded | Annual |
NDH003 | Blood glucose monitoring | As above, + patients with a history of gestational diabetes | HbA1c or FPG result recorded | Annual
|
🏥 Public Health, Weight Management, and Smoking [QOF]
🏥 Public Health, Weight Management, and Smoking [QOF]
Code | Name | Who & when to recall | What counts as complete | Cadence |
BP002 | BP check (age ≥45) | Patients aged 45+ with no BP recorded in last 5 years | Blood pressure recorded | Every 5 years |
OB004 | Obesity: referral to weight management | Adults with obesity not yet referred to a weight management programme within 90 days of the BMI being recorded
| Referral to weight management programme | Annual |
OB005 | Obesity: shared decision-making discussion | Eligible patients not yet offered a shared decision-making discussion, NICE-approved medicines management and referral to a behavioural support programme | Shared decision-making discussion, weight-management pharmacotherapy offer, and behavioural support programme referral all recorded in the current QOF year. | Annual |
SMOK002 | Smoking status – at-risk patients | LTC patients (asthma, COPD, diabetes, CVD, SMI, etc.) with no status recorded in last 12m | Smoking status recorded | Annual |
SMOK004 | Cessation offer – general smokers | Patients aged 15+ who smoke and have had no cessation offer in last 24m | Smoking cessation advice or referral recorded | Every 24 months |
SMOK005 💰 | Cessation offer – at-risk smokers | Smokers with LTCs (diabetes, CVD, COPD, SMI, etc.) and no cessation offer in last 12m | Cessation support offer recorded | Annual |
🦠 RSV (Respiratory Syncytial Virus) [Vaccinations]
🦠 RSV (Respiratory Syncytial Virus) [Vaccinations]
Code | Name | Who & when to recall | What counts as complete | Cadence |
RSV001 | RSV – older adult routine | Patients aged ≥75 with no RSV vaccine; rejects contraindications and 12m declines | RSV vaccine recorded | One-off (age 75 trigger) |
💉 Shingles [Vaccinations]
💉 Shingles [Vaccinations]
Code | Name | Who & when to recall | What counts as complete | Cadence |
HIPPOSHING_IC_02 | Shingrix dose 2 (immunocompetent) | Same cohort as IC_01 (catch-up extended to age 80) with 1st Shingrix recorded ≥6 months ago. Programme ends 31 Aug 2028. | 2nd Shingrix dose recorded ≥8 weeks after 1st | Dose-dependent (≥6m after dose 1) |
HIPPOSHING_CX_01 | Shingrix dose 1 (immunocompromised, 18+) | Patients aged ≥18 flagged by practice as 'requires shingles vaccine' (REQSHVAC code) | 1st Shingrix dose recorded | One-off (until vaccinated) |
HIPPOSHING_CX_02 | Shingrix dose 2 (immunocompromised, 18+) | Same cohort as CX_01 with 1st Shingrix recorded ≥8 weeks (56 days) ago | 2nd Shingrix dose recorded ≥8 weeks after 1st | Dose-dependent (≥8w after dose 1) |
VI004 | Shingles vaccine (ages 70–79) | Patients who turn 80 in the reporting year (or 81 with specific first-dose timing rules) without a shingles vaccination recorded between ages 70–79 | Shingles vaccine recorded (GP, other healthcare provider, or second-dose code) | One-off |
💊 SPS (and other) Meds Monitoring [NICE]
💊 SPS (and other) Meds Monitoring [NICE]
Code | Name | Who & when to recall | What counts as complete | Cadence |
SPSMMONGSTABAA | ACE inhibitor / ARB monitoring | Patients issued an ACEI or ARB in the last 3 months, missing monitoring | U&Es and BP in last 12 months (or bloods and BP declined) | Annual |
SPSMMONGSTABALF | Alfacalcidol monitoring | Patients issued alfacalcidol in the last 3 months, missing monitoring | Bone profile, parathyroid hormone, U&Es and magnesium in last 3 months (or bloods declined) | 3-monthly |
SPSMMONGSTABACI | Acetylcholinesterase inhibitor monitoring | Patients issued an AChE inhibitor in the last 3 months, missing monitoring | Pulse in last 6 months (or examination declined) | 6-monthly |
SPSMMONGSTABCARB | Carbimazole monitoring | Patients issued carbimazole in last 3 months | TFTs recorded or bloods declined in last 3 months | 3-monthly |
SPSMMONGSTABCORT | Corticosteroid monitoring | Patients with ≥3 corticosteroid issues in last 12 months, latest in last 3 months, missing monitoring | HbA1c, U&Es, lipids and BP in last 12 months (or bloods and BP declined) | Annual |
SPSMMONGSTABDIG | Digoxin monitoring | Patients issued digoxin in last 3 months | Calcium, U&Es and Mg in last 12 months (or bloods declined) | Annual |
SPSMMONGSTABEPL | Eplerenone monitoring | Patients issued eplerenone in the last 3 months, missing monitoring | U&Es in last 6 months (or bloods declined) | 6-monthly |
SPSMMONGSTABFURO | Furosemide monitoring | Patients issued furosemide in last 3 months | U&Es in last 6 months (or bloods declined) | 6-monthly |
HIPPOGOUTMON001 | Gout monitoring: Allopurinol/febuxostat monitoring | Patients issued allopurinol or febuxostat in last 3 months due blood and urine monitoring | Urate, U&Es, HbA1c, lipid profile and uACR in last 12 months | Annual |
SPSMMONGSTABHYD | Hydroxycarbamide monitoring | Patients issued hydroxycarbamide in last 3 months | FBC, LFTs, U&Es, LDH and urate in last 3 months (or bloods declined) | 3-monthly |
SPSMMONGSTABHCQ | Hydroxychloroquine monitoring | Patients issued hydroxychloroquine in the last 3 months, missing monitoring | LFTs, U&Es and weight in last 12 months (or bloods declined and weight declined) | Annual |
SPSMMONGSTABMERC | Mercaptopurine monitoring | Patients issued mercaptopurine in last 3 months | FBC, LFTs, U&Es in last 3 months (or bloods declined) | 3-monthly |
SPSMMONGSTABMINO | Minocycline monitoring | Patients with ≥2 minocycline issues in last 6 months, latest in last 3 months, missing monitoring | U&Es, LFTs and FBC in last 3 months (or bloods declined) | 3-monthly |
SPSMMONGSTABMYCO | Mycophenolate mofetil monitoring | Patients issued mycophenolate mofetil in the last 3 months, missing monitoring | LFTs, FBC and U&Es in last 12 weeks (or bloods declined) | 3-monthly |
SPSMMONGSTABNIT | Nitrofurantoin monitoring | Patients with ≥3 nitrofurantoin issues in last 12 months, latest in last 3 months, missing monitoring | U&Es and LFTs in last 12 months (or bloods declined) | Annual |
SPSMMONGSTABPEN | Penicillamine monitoring | Patients issued penicillamine in the last 3 months, missing monitoring | LFTs, FBC, U&Es and urinalysis in last 3 months (or bloods and urine dip declined) | 3-monthly |
SPSMMONGSTABPIO | Pioglitazone monitoring | Patients issued pioglitazone in last 3 months | LFTs, HbA1c and weight in last 12 months (or bloods and weight declined) | Annual |
SPSMMONGSTABSTAT | Statin monitoring (SPS ongoing) | Patients issued a statin in last 3 months | LFTs and lipids in last 12 months (or bloods declined) | Annual |
SPSMMONGSTABSULF | Sulfasalazine monitoring | Patients issued sulfasalazine in the last 3 months, missing monitoring | U&Es, LFTs and FBC in last 12 months (or bloods declined) | Annual |
SPSMMONGSTABVALP | Valproate monitoring | Patients issued valproate in the last 3 months, missing monitoring | FBC, LFTs and BMI in last 12 months (or bloods and weight declined) | Annual |
💰Income Protected (Summary)
Code | Name | Who & when to recall | What counts as complete | Cadence |
AST008 💰 | Smoking status (young asthmatics) | Asthma patients aged ≤19, no smoking status in last 12m | Personal smoking status, second-hand smoke exposure, or no second-hand smoke exposure recorded in the last 12 months. | Annual |
COPD014 💰 | Pulmonary rehab offer | COPD patients with MRC score ≥3, not previously offered rehab | Offer of referral to pulmonary rehab recorded | One-off (per MRC trigger) |
MH021 💰 | SMI annual health check (all 6) | SMI patients missing ≥1 of: BP, BMI, alcohol, smoking, lipids, HbA1c | All 6 checks completed and recorded in last 12m | Annual |
SMOK005 💰 | Cessation offer – at-risk smokers | Smokers with LTCs (diabetes, CVD, COPD, SMI, etc.) and no cessation offer in last 12m | Cessation support offer recorded | Annual |
🎯 Treat to Target Indicators
These indicators have a defined measurement target (e.g. blood pressure or HbA1c) that the patient must meet.
If the latest reading on the patient's record does not meet the target, or if no reading is recorded at all, the patient will continue to be recalled until the target is achieved and recorded.
Code | Indicator Description |
DM020 🎯 | HbA1c at or below target (≤ 58 mmol/mol) — diabetes, no moderate/severe frailty |
DM021 🎯 | HbA1c at or below higher target (≤ 75 mmol/mol) — diabetes, with moderate/severe frailty |
DM036 🎯 | BP at or below target (≤ 140/90 mmHg or equivalent home reading) — hypertension, ≥ 79 yrs |
CD001 🎯 | BP at or below target (≤ 140/90 mmHg or equivalent home reading) — hypertension, < 80 yrs |
CD002 🎯 | BP at or below target (≤ 150/90 mmHg or equivalent home reading) — hypertension, ≥ 80 yrs |
HYP008 🎯 | BP at or below target (≤ 140/90 mmHg or equivalent home reading) — hypertension, < 80 yrs |
HYP009 🎯 | BP at or below target (≤ 150/90 mmHg or equivalent home reading) — hypertension, ≥ 80 yrs |
HYP010 🎯 | BP at or below target (≤ 140/90 mmHg) — hypertension, < 80 yrs, no moderate/severe frailty |
HYP011 🎯 | BP at or below target (≤ 150/90 mmHg) — hypertension, ≥ 80 yrs, no moderate/severe frailty |
CHD015 🎯 | BP at or below target (≤ 140/90 mmHg or equivalent home reading) — CHD, < 80 yrs |
CHD016 🎯 | BP at or below target (≤ 150/90 mmHg or equivalent home reading) — CHD, ≥ 80 yrs |
STIA014 🎯 | BP at or below target (≤ 140/90 mmHg or equivalent home reading) — stroke/TIA, < 80 yrs |
STIA015 🎯 | BP at or below target (≤ 150/90 mmHg or equivalent home reading) — stroke/TIA, ≥ 80 yrs |
CHOL004 🎯 | Cholesterol at or below target: latest LDL ≤ 2.0 mmol/L or latest non-HDL ≤ 2.6 mmol/L (LDL takes priority if both exist on the same date). Applies to patients on the CHD, PAD, or Stroke/TIA registers with a cholesterol reading in the last 12 months. |
💡 Can I select multiple targets?
Yes — Hippo recalls patients who are due for at least one of the targets you select. Once they've received the care, they drop off the list.
