🧾 Understanding the CQC Indicators in Hippo

Hippo includes a full set of CQC (Care Quality Commission) monitoring indicators designed to help practices meet clinical safety and medicines management requirements.

These indicators track whether key safety checks (like blood tests, kidney function, weight, and reviews) have been completed for patients on high-risk or regularly monitored medicines.

You can use them in Recall Campaigns to automate patient invitations or view them in Indicator Performance to track compliance.

💊 Medication Monitoring Indicators

CQCDOAC000–CQCDOAC007 — DOAC Monitoring

These indicators help ensure safe prescribing for patients on DOACs by checking their weight, renal function, and blood test results.

Indicator	Description	What It Checks
CQCDOAC000	Weight – patients on DOAC	Weight recorded in the last 12 months (needed for CrCl dosing).
CQCDOAC001	CrCl ever recorded	A creatinine clearance has been calculated at least once.
CQCDOAC001A	Serum creatinine ever recorded	A serum creatinine has been taken at least once.
CQCDOAC001B	CrCl ever, with valid weight + creatinine	CrCl recorded, and weight in the last 12 months, and a serum creatinine on file.
CQCDOAC002	Annual CrCl	Creatinine clearance in the last 12 months.
CQCDOAC002A	Annual serum creatinine	Serum creatinine in the last 12 months.
CQCDOAC002B	Annual CrCl, with valid weight + creatinine	CrCl in the last 12 months, and weight in the last 12 months, and serum creatinine in the last 12 months.
CQCDOAC003	3-month CrCl – CKD4/5	CrCl in the last 3 months for patients with CKD stage 4 or 5.
CQCDOAC003A	3-month creatinine – CKD4/5	Serum creatinine in the last 3 months for patients with CKD stage 4 or 5.
CQCDOAC003B	3-month CrCl – CKD4/5, with valid weight + creatinine	CrCl in the last 3 months, plus weight in the last 12 months and serum creatinine in the last 3 months.
CQCDOAC004	6-month CrCl – CKD3	CrCl in the last 6 months for patients with CKD stage 3.
CQCDOAC004A	6-month creatinine – CKD3	Serum creatinine in the last 6 months for patients with CKD stage 3.
CQCDOAC004B	6-month CrCl – CKD3, with valid weight + creatinine	CrCl in the last 6 months, plus weight in the last 12 months and serum creatinine in the last 6 months.
CQCDOAC005	Annual haemoglobin	Hb checked in the last 12 months.
CQCDOAC006	Review – severely low haemoglobin	Patients whose most recent Hb is below 90 g/L have had an anticoagulation review since that Hb result.
CQCDOAC007	Appropriate kidney function	Latest creatinine clearance is in safe range for the drug: ≥ 30 if on dabigatran, ≥ 15 otherwise.

⚠️ The naming pattern across the DOAC suite is:

plain number = creatinine clearance
A = serum creatinine
B = creatinine clearance with up-to-date weight and creatinine.

Patients only appear in B-version denominators once both supporting values are on file.

CQCWARFARIN001–002 — Warfarin Monitoring

Indicator	Description	What It Checks
CQCWARFARIN001	INR monitoring	INR in the last 3 months, or a self-monitoring code in the last 12 months.
CQCWARFARIN002	Review – high INR	Patients with a worrying INR result in the last 6 months — either one INR ≥ 8 or two or more INR ≥ 5 — have had an anticoagulation review since that result.

CQCMETFORMIN001–002 — Metformin Monitoring

Indicator	Description	What It Checks
CQCMETFORMIN001	Kidney function – metformin	eGFR in the last 12 months.
CQCMETFORMIN002	Satisfactory kidney function – metformin	Of metformin patients with an eGFR in the last 12 months, the proportion whose most recent eGFR is ≥ 30 (i.e., kidney function is still within safe range for metformin).

CQCAMIODERONE001 — Amiodarone Monitoring

Indicator	Description	What It Checks
CQCAMIODERONE001	Function checks – amiodarone	U&Es, LFTs and TFTs all in the last 6 months.

CQCLI001–002 — Lithium Monitoring

Indicator	Description	What It Checks
CQCLI001	Serum lithium level	Lithium level checked in the last 3 months.
CQCLI002	Ca, kidney, and thyroid monitoring	Calcium, U&Es and TFTs all in the last 6 months.

💉 DMARDs Indicators

CQCMET001 / CQCLEF001 / CQCAZA001 — DMARD Monitoring

Indicator	Description	What It Checks
CQCMET001	Methotrexate monitoring	FBC, U&Es and LFTs all in the last 12 weeks.
CQCLEF001	Leflunomide monitoring	FBC, U&Es, LFTs, BP and weight all in the last 12 weeks.
CQCAZA001	Azathioprine monitoring	FBC, U&Es and LFTs all in the last 12 weeks.

CQCACEARB001 / CQCALDANT001 — Heart & Kidney Function Monitoring

Indicator	Description	What It Checks
CQCACEARB001	Kidney function – ACEi/ARB	Creatinine or eGFR in the last 12 months.
CQCALDANT001	Kidney function – heart failure (aldosterone antagonists)	Patients on an aldosterone antagonist who have a current heart failure diagnosis have had a creatinine or eGFR in the last 6 months. (Excludes patients whose HF has been coded as resolved.)

🦋 Thyroid Monitoring

CQC_HYPO — Hypothyroidism Monitoring

Indicator	Description	What It Checks
CQC_HYPO	Hypothyroidism monitoring	Patients issued hypothyroid medication within the last 12 months have had a TSH (thyroid function) check within the last 12 months.

🔍 Missed Diagnoses Indicators

CQC_MISDIAG_CKD / CQC_MISDIAG_DM — Case-finding for undiagnosed conditions

Indicator	Description	What It Checks
CQC_MISDIAG_CKD	Possible undiagnosed CKD	Patients who appear to meet CKD diagnostic criteria from their blood results but do not have a coded CKD diagnosis.
CQC_MISDIAG_DM	Possible undiagnosed diabetes	Patients who appear to meet diabetes diagnostic criteria from their blood results but do not have a coded diabetes diagnosis.

🛑 Drug Safety Alert Indicators

CQCSAFETYALERT001–006 and CQCSAFETYALERT008–010 — MHRA and Drug Safety Reviews

These nine indicators identify patients taking higher-risk medicines, or combinations of medicines, who may require a documented medication review, safety advice or additional monitoring.

Indicator	Description	What It Checks
CQCSAFETYALERT001	Hydrochlorothiazide – skin cancer information	Confirms that patients taking hydrochlorothiazide have received information about skin cancer risk.
CQCSAFETYALERT002	High-dose SSRI in older adults – review	Patients aged 65 or over taking a high-dose SSRI have had a medication review.
CQCSAFETYALERT003	Clopidogrel and PPI – review	Patients prescribed clopidogrel alongside a proton pump inhibitor have had a medication review.
CQCSAFETYALERT004	Febuxostat with cardiovascular disease – review	Patients taking febuxostat who also have cardiovascular disease have had a medication review.
CQCSAFETYALERT005	New fentanyl patch without prior opioid – review	Patients started on a fentanyl patch within the last year, without previous opioid exposure, have had a medication review.
CQCSAFETYALERT006	Mirabegron – blood pressure monitoring	Patients taking mirabegron have had their blood pressure monitored.
CQCSAFETYALERT008	SGLT-2 inhibitors – safety information	Patients taking an SGLT-2 inhibitor have received information about ketoacidosis and Fournier’s gangrene.
CQCSAFETYALERT009	Simvastatin 40/80 mg with a CYP3A4-inhibiting calcium channel blocker – review	Patients taking simvastatin 40 mg or 80 mg alongside a relevant calcium channel blocker have had a medication review.
CQCSAFETYALERT010	Teratogenic medicines – review	Women of childbearing potential taking teratogenic medicines have had a medication review.

💡 Please note: There is no CQCSAFETYALERT007 indicator. The numbering moves directly from 006 to 008.

💡 Why These Indicators Matter

CQC indicators help practices:

Stay compliant with medicines safety and CQC standards
Identify patients overdue for essential blood monitoring
Ensure safe prescribing for high-risk or renal-dependent drugs
Provide clear audit evidence for regulators and PCNs

🧭 Where to Find Them in Hippo

You can find CQC indicators in:

Recall Campaign setup → under the “CQC” framework
Indicator Performance dashboard → to monitor completion and progress