Hippo Labs uses the official NHS England QOF Business Rules to help practices manage secondary prevention and blood pressure control in patients with stroke or transient ischaemic attack (TIA).
💬 Just a reminder: these indicators aren’t clinical guidelines — they define which patients appear for recall, how achievement is calculated, and where pitfalls can occur.
📋 The Stroke Register
Register | Includes | Purpose |
STIA_REG | Patients with a diagnosis of stroke or TIA | Used for all Stroke/TIA indicators |
✅ In short: any patient with a recorded stroke or TIA diagnosis will appear on the Stroke register.
🩺 The Indicators
🧾 STIA001 — Stroke/TIA Register
Measures:
Whether the practice maintains an up-to-date register of patients diagnosed with stroke or TIA.
✅ In short: this is an administrative indicator confirming the register exists — no action required beyond ensuring coding is correct.
💊 STIA007 — Antiplatelet or Anticoagulant Therapy
Measures:
% of patients with a non-haemorrhagic stroke or TIA who have a record that an antiplatelet or anticoagulant is being taken in the last 12 months.
Counts as complete if:
A prescription or record of any of the following within 12 months:
Salicylate (aspirin)
Clopidogrel
Dipyridamole
Oral anticoagulant (e.g. DOAC or warfarin)
Exclusions (Personalised Care Adjustments):
Contraindications or intolerance to all relevant agents.
Stroke/TIA care unsuitable or declined.
Two invitations for stroke care review (≥7 days apart) with no attendance.
Diagnosis or registration within the last 3 months.
⚠️ Common pitfalls:
Patient coded with haemorrhagic stroke (excluded).
Missing active prescription despite long-term use.
Contraindication recorded for one drug but not others (e.g. aspirin contraindicated but clopidogrel suitable).
Second invite codes remove the patient from the indicator even if opportunistic review still possible.
✅ In short: every eligible patient with a non-haemorrhagic stroke or TIA should have active antiplatelet or anticoagulant therapy recorded within the last 12 months, unless contraindicated or declined.
🩸 STIA014 — BP ≤140/90 mmHg (Aged ≤79 years)
Measures:
% of patients aged ≤79 years with a history of stroke or TIA whose most recent BP reading in the last 12 months is ≤140/90 mmHg, or ≤135/85 mmHg if taken at home/ambulatory.
Counts as complete if:
Latest clinic BP ≤140/90,
orLatest home/ambulatory BP ≤135/85,
andRecorded within the last 12 months.
Exclusions (PCAs):
Care unsuitable or declined.
Patient declined or unable to have BP taken (clinic/home/ambulatory).
Receiving maximal therapy for BP control.
Two invitations (≥7 days apart) for review with no attendance.
New diagnosis (≤9 months) or new registration (≤9 months).
⚠️ Common pitfalls:
BP coded as text rather than numeric.
Missing both systolic and diastolic values.
Home/ambulatory BP not coded in the correct cluster.
Clinical systems auto-remove prompts after two invites — even though care may still be delivered opportunistically.
✅ In short: for patients under 80, the target is ≤140/90 (clinic) or ≤135/85 (home/ambulatory).
❤️ STIA015 — BP ≤150/90 mmHg (Aged ≥80 years)
Measures:
% of patients aged ≥80 years with a history of stroke or TIA whose most recent BP reading in the last 12 months is ≤150/90 mmHg, or ≤145/85 mmHg if taken at home/ambulatory.
Counts as complete if:
Latest clinic BP ≤150/90,
orLatest home/ambulatory BP ≤145/85,
andRecorded within the last 12 months.
Exclusions (PCAs):
Care unsuitable or declined.
Patient declined or unable to have BP taken.
Receiving maximal BP therapy.
Two invitations (≥7 days apart) for review with no attendance.
New diagnosis (≤9 months) or new registration (≤9 months).
⚠️ Common pitfalls:
Confusing 140/90 and 150/90 thresholds across age groups.
BP recorded outside 12-month window.
BP recorded but not linked to correct code type (clinic vs home).
Prompts disappearing after second invite code.
✅ In short: for patients aged 80+, the target is ≤150/90 (clinic) or ≤145/85 (home/ambulatory).
🧩 Summary Table
Indicator | Focus | Who It Applies To | What It Measures | Target |
STIA001 | Register | All stroke/TIA patients | Maintenance of Stroke/TIA register | N/A |
STIA007 | Secondary prevention | Non-haemorrhagic stroke/TIA | Antiplatelet or anticoagulant recorded | In last 12 months |
STIA014 | BP control (<80y) | Stroke/TIA patients aged ≤79 | Last BP ≤140/90 (clinic) or ≤135/85 (home) | In last 12 months |
STIA015 | BP control (80+y) | Stroke/TIA patients aged ≥80 | Last BP ≤150/90 (clinic) or ≤145/85 (home) | In last 12 months |
🌟 Why This Matters
Following these indicators helps practices:
Optimise secondary prevention for all stroke/TIA patients.
Ensure effective BP control to reduce recurrence risk.
Demonstrate QOF compliance and proactive cardiovascular care.
✅ In short: the Stroke and TIA indicators ensure that every patient with a past stroke or TIA receives secondary prevention and annual BP monitoring within evidence-based targets.
📚 Sources
NHS England QOF Business Rules v50.0 (Stroke and TIA, April 2025)
Primary Care Domain Reference Sets (TRUD Portal)