Hippo Labs uses the official NHS England QOF Business Rules v50.0 to help practices deliver safe, consistent management for patients with coronary heart disease — from maintaining an accurate register to monitoring blood pressure and secondary prevention medication.
💬 Just a reminder: these indicators aren’t clinical guidelines — they’re operational definitions used for QOF measurement. They define which patients appear for recall, how achievement is calculated, and where gaps may occur.
📋 The CHD Register (CHD001)
The CHD register includes patients with a diagnosis of coronary heart disease (CHD).
It forms the foundation for all CHD indicators.
Patients appear on the register if they:
Have a coded diagnosis of CHD recorded in their medical record.
✅ In short: all patients with a coded CHD diagnosis should appear on the register.
🩺 The Indicators
These indicators apply only to patients on the CHD register. Together, they measure safe and consistent secondary prevention — ensuring patients receive antiplatelet/anticoagulant therapy and maintain controlled blood pressure.
💊 CHD005 — Antiplatelet or Anticoagulant Therapy
Measures:
% of patients with CHD who have a record in the last 12 months that they are taking:
Aspirin,
An alternative antiplatelet (e.g. clopidogrel), or
An oral anticoagulant.
Counts as complete if:
The patient has a prescription or code for salicylates, clopidogrel, or an oral anticoagulant in the past 12 months.
Exclusions (Personalised Care Adjustments):
Contraindications to all three agents (aspirin, clopidogrel, and anticoagulants)
Declined all three in the past 12 months
CHD care deemed unsuitable
Newly diagnosed or registered within the last 3 months
Two care-review invitations sent ≥7 days apart with no response (removed for payment only)
⚠️ Common pitfalls:
Missing contraindication or decline codes — leaving apparent gaps in care
Using medication free text rather than coded prescriptions
Confusing antiplatelets with anticoagulants (must be coded correctly)
Failing to record over-the-counter aspirin if documented in the record
✅ In short: every CHD patient should be coded as receiving aspirin, clopidogrel, or anticoagulant therapy — or have a valid exclusion.
🩸 CHD015 — Blood Pressure Control (Under 80s)
Measures:
% of CHD patients aged 79 or under with a last BP reading ≤140/90 mmHg, or equivalent home/ambulatory BP ≤135/85 mmHg, within the last 12 months.
Counts as complete if:
Latest BP (clinic, home, or ambulatory) meets target:
≤140/90 mmHg for clinic BP, or
≤135/85 mmHg for home/ambulatory BP,
Recorded in the last 12 months.
Exclusions (Personalised Care Adjustments):
Maximal BP therapy recorded
Declined or unsuitable for BP monitoring
Newly diagnosed/registered within 9 months
Two CHD review invitations sent ≥7 days apart with no attendance (removed for payment only)
⚠️ Common pitfalls:
Using home BP readings without coding as “home/ambulatory”
Recording only one value (systolic or diastolic)
BP recorded but no date entered
Above-target BPs not followed up with further measurement or invite
✅ In short: CHD patients under 80 should have a BP ≤140/90 (or ≤135/85 at home) recorded in the last 12 months.
🧓 CHD016 — Blood Pressure Control (80 and Over)
Measures:
% of CHD patients aged 80 or over with a last BP reading ≤150/90 mmHg, or equivalent home/ambulatory BP ≤145/85 mmHg, within the last 12 months.
Counts as complete if:
Latest BP (clinic or home/ambulatory) meets target:
≤150/90 mmHg for clinic BP, or
≤145/85 mmHg for home/ambulatory BP,
Recorded in the last 12 months.
Exclusions (Personalised Care Adjustments):
Maximal BP therapy recorded
Declined or unsuitable for BP monitoring
Newly diagnosed/registered within 9 months
Two CHD review invitations sent ≥7 days apart with no attendance (removed for payment only)
⚠️ Common pitfalls:
Not applying the correct age-specific BP target
Misclassified home readings as clinic readings
Missing coded date or diastolic value
Above-target BPs not rechecked before year-end
✅ In short: CHD patients aged 80+ should have a BP ≤150/90 (or ≤145/85 at home) recorded in the last 12 months.
🧩 Putting It All Together
Indicator | Focus | Who It Applies To | What It Shows | What to Do |
CHD005 | Secondary prevention medication | All CHD patients | Whether appropriate antiplatelet/anticoagulant therapy is prescribed | Code aspirin, clopidogrel, or anticoagulant therapy (or record contraindication/decline) |
CHD015 | BP control (under 80s) | CHD patients aged ≤79 | BP management and cardiovascular risk reduction | Record latest BP ≤140/90 (≤135/85 home) |
CHD016 | BP control (80+) | CHD patients aged ≥80 | Safe, age-appropriate BP management | Record latest BP ≤150/90 (≤145/85 home) |
🌟 Why This Matters
Following these indicators helps practices:
Maintain a validated register of CHD patients
Monitor blood pressure effectively and safely by age group
Ensure consistent prescription of antiplatelet/anticoagulant therapy
Demonstrate QOF compliance and reduce cardiovascular risk
✅ In short: the CHD indicators ensure accurate registers, safe BP targets, and consistent secondary prevention for all patients with coronary heart disease.