Hippo Labs uses the official NHS England QOF Business Rules v50.0 to help practices monitor and recall patients with non-diabetic hyperglycaemia (NDH) — ensuring timely re-testing and reducing the risk of progression to type 2 diabetes.
💬 Just a reminder: this indicator isn’t a clinical guideline — it defines how QOF measures NDH management, which patients appear for recall, and what counts as complete.
📋 The NDH Register (NDH_REG)
The NDH register includes patients aged 18 years or over with a diagnosis of non-diabetic hyperglycaemia, who do not have an active or unresolved diabetes diagnosis.
Patients appear on the register if they:
Are aged 18+, and
Have a diagnosis of non-diabetic hyperglycaemia, pre-diabetes, or impaired glucose tolerance, and
Have never been diagnosed with diabetes, or had a diabetes diagnosis that was later resolved.
✅ In short: this register includes adults with NDH, pre-diabetes, or IGT — excluding anyone with unresolved diabetes.
🩺 The Indicator
🧪 NDH002 — HbA1c or Fasting Glucose in the Last 12 Months
Measures:
% of patients with non-diabetic hyperglycaemia who have had an HbA1c or fasting plasma glucose test in the past 12 months.
Counts as complete if:
HbA1c (IFCC) recorded within the last 12 months,
orFasting plasma glucose recorded within the last 12 months.
Exclusions (Personalised Care Adjustments):
Unsuitable for NDH review.
Declined glucose testing or NDH care.
Two NDH review invitations sent ≥7 days apart with no response (removed for payment only — Hippo continues to flag for recall).
New diagnosis within the last 3 months.
Newly registered within the last 3 months.
⚠️ Common pitfalls:
Recording results without recognised SNOMED codes.
Using total glucose codes instead of fasting or HbA1c.
NDH diagnosis coded but no annual retesting reminder.
Forgetting to re-test newly diagnosed patients once 3-month grace period ends.
✅ In short: every patient with NDH should have either an HbA1c or fasting glucose result recorded within the past 12 months — or a valid exclusion coded.
🧩 Putting It All Together
Indicator | Focus | Who It Applies To | What It Shows | What to Do |
NDH_REG | Register | Adults (18+) with NDH, IGT, or pre-diabetes | Inclusion for recall | Ensure NDH/pre-diabetes/IGT diagnoses are coded and unresolved |
NDH002 | Annual testing | NDH register patients | Monitoring of HbA1c or fasting glucose | Record HbA1c or fasting glucose test within the past 12 months |
🌟 Why This Matters
Following this indicator helps practices:
Maintain an accurate NDH register.
Identify patients at highest risk of developing type 2 diabetes.
Ensure regular monitoring and early intervention.
Demonstrate QOF compliance and proactive pre-diabetes management.
✅ In short: the NDH indicator ensures every patient with non-diabetic hyperglycaemia is reviewed and re-tested at least once a year to support prevention and early intervention.
📚 Sources
NHS England QOF Business Rules v50.0 (Non-Diabetic Hyperglycaemia, April 2025)
Primary Care Domain Reference Sets (TRUD Portal)