Hippo Labs uses the official NHS England QOF Business Rules to help practices monitor patients with hypertension — ensuring accurate registers, controlled blood pressure readings, and consistent recall processes.
💬 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 Hypertension Register (HYP001)
The hypertension register includes all patients with an unresolved diagnosis of hypertension.
It’s the foundation for all hypertension indicators (HYP008 and HYP009).
Patients appear on the register if they:
Have a coded diagnosis of hypertension, and
Have no “hypertension resolved” code recorded.
✅ In short: every patient with an active, unresolved hypertension diagnosis should appear on the register.
🩺 The Indicators
These indicators measure how well blood pressure is managed and recorded in hypertensive patients — with age-adjusted targets for under 80s and over 80s.
💓 HYP008 — Blood Pressure Control (Under 80s)
Measures:
% of patients aged 79 or under with hypertension whose most recent BP (in the past 12 months) was:
≤140/90 mmHg (clinic BP), or
≤135/85 mmHg (home or ambulatory BP).
Counts as complete if:
Latest clinic BP ≤140/90 mmHg, or
Latest home/ambulatory BP ≤135/85 mmHg,
recorded within the last 12 months.
Exclusions (Personalised Care Adjustments):
On maximal blood pressure therapy.
BP care unsuitable for the patient.
Declined BP monitoring (clinic, home, or ambulatory).
Declined hypertension indicator care (HYPPCADEC).
Two hypertension invites ≥7 days apart with no attendance (removed for payment only — Hippo continues to flag for recall).
Newly diagnosed or registered within the last 9 months.
⚠️ Common pitfalls:
Recording a BP reading without both systolic and diastolic values.
Using only total systolic readings (missing diastolic).
Entering home BP readings under clinic BP codes.
Forgetting to code declines or maximal therapy (leaving apparent gaps).
✅ In short: all hypertensive patients under 80 should have a recorded BP ≤140/90 (clinic) or ≤135/85 (home/ambulatory) within the past 12 months.
❤️ HYP009 — Blood Pressure Control (80 and Over)
Measures:
% of patients aged 80 or over with hypertension whose most recent BP (in the past 12 months) was:
≤150/90 mmHg (clinic BP), or
≤145/85 mmHg (home or ambulatory BP).
Counts as complete if:
Latest clinic BP ≤150/90 mmHg, or
Latest home/ambulatory BP ≤145/85 mmHg,
recorded within the last 12 months.
Exclusions (Personalised Care Adjustments):
On maximal BP therapy.
BP care unsuitable or declined (clinic/home/ambulatory).
Declined hypertension quality indicator care.
Two hypertension invites ≥7 days apart with no attendance (removed for payment only).
Newly diagnosed or registered within the last 9 months.
⚠️ Common pitfalls:
Recording home BP under the clinic BP cluster.
Not differentiating BP targets by age group.
Forgetting to enter valid exclusion codes (declines, unsuitable, maximal therapy).
BP entered as text or under “historical” readings rather than a coded value.
✅ In short: all hypertensive patients aged 80+ should have a recorded BP ≤150/90 (clinic) or ≤145/85 (home/ambulatory) within the last 12 months.
🧩 Putting It All Together
Indicator | Focus | Who It Applies To | What It Shows | What to Do |
HYP001 | Register | All patients with hypertension | Accuracy of hypertension register | Ensure all unresolved hypertension diagnoses are coded |
HYP008 | BP control (under 80s) | Hypertension patients aged ≤79 | BP control at target levels | Record clinic BP ≤140/90 or home BP ≤135/85 in last 12 months |
HYP009 | BP control (80+) | Hypertension patients aged ≥80 | BP control at target levels for older adults | Record clinic BP ≤150/90 or home BP ≤145/85 in last 12 months |
🌟 Why This Matters
Following these indicators helps practices:
Maintain accurate hypertension registers.
Monitor blood pressure systematically by age group.
Reduce cardiovascular risk through proactive recall and review.
Demonstrate QOF compliance and safe, personalised hypertension management.
✅ In short: the Hypertension Indicators ensure every patient with high blood pressure is monitored annually and remains within target ranges for their age group.
📚 Sources
NHS England QOF Business Rules v50.0 (Hypertension, April 2025)
Primary Care Domain Reference Sets (TRUD Portal)