Hippo’s Diabetes indicators are based on the NICE 8 Care Processes (8CP) and follow NHS England data extraction logic, with additional refinements developed by Hippo’s clinical and data teams.
They help practices identify patients on the diabetes register, track completion of the eight essential care processes, and manage outstanding reviews proactively.
📋 The Diabetes Register
The Diabetes Register includes all patients aged 17 and over with an unresolved diabetes diagnosis (Type 1 or Type 2).
Patients appear on the register if they:
Have a coded diagnosis of diabetes, and
Have no “diabetes resolved” code recorded, and
Are currently registered for GMS.
✅ In short: the register covers all active diabetes patients aged 17+.
🩺 The Indicators
🧾 HIPPODM8CP001 — Completion of All 8 Care Processes
Measures:
% of diabetes patients who have had all eight NICE Care Processes completed in the last 12 months.
The 8 care processes are:
HbA1c (IFCC)
Blood pressure
Cholesterol
Serum creatinine
Urine albumin:creatinine ratio (ACR)
Foot examination & risk classification
BMI
Smoking status
Counts as complete if:
All eight checks are recorded within the last 12 months.
⚠️ Common pitfalls:
One or more care processes recorded outside the 12-month window.
Using free-text or non-QOF-aligned codes (e.g. local template entries).
HbA1c recorded in DCCT units rather than IFCC mmol/mol.
✅ In short: every diabetes patient should have all eight care processes completed and coded each year.
🩸 HIPPODM8CP001a — HbA1c Recording
Measures:
% of diabetes patients with a recorded IFCC HbA1c result within the last 12 months.
✅ In short: an up-to-date HbA1c (mmol/mol) must be recorded each year — serum fructosamine can be used where HbA1c is unsuitable.
💓 HIPPODM8CP001b — Blood Pressure Recording
Measures:
% of diabetes patients with a BP reading in the last 12 months.
✅ In short: record clinic or home BP (systolic and diastolic) within the past year.
🧪 HIPPODM8CP001c — Serum Cholesterol Recording
Measures:
% of diabetes patients with a cholesterol result recorded in the last 12 months.
✅ In short: at least one lipid profile (total or non-HDL cholesterol) recorded annually.
🧬 HIPPODM8CP001d — Serum Creatinine Recording
Measures:
% of diabetes patients with a serum creatinine result in the last 12 months.
✅ In short: ensures kidney function is checked each year.
💧 HIPPODM8CP001e — Urine Albumin:Creatinine Ratio (ACR)
Measures:
% of diabetes patients with a urine albumin:creatinine ratio recorded in the last 12 months.
✅ In short: record ACR annually to screen for early diabetic nephropathy.
🦶 HIPPODM8CP001f — Foot Examination & Risk Classification
Measures:
% of diabetes patients who have had a foot examination and risk classification in the last 12 months.
Risk levels include:
Low (normal sensation, palpable pulses)
Increased (neuropathy or absent pulses)
High (neuropathy or absent pulses + deformity/skin changes/previous ulcer)
Ulcerated
✅ In short: code both the examination and the risk category every year.
⚖️ HIPPODM8CP001g — BMI Recording
Measures:
% of diabetes patients with a BMI recorded in the last 12 months.
✅ In short: weight and height must both be entered to calculate BMI — record this annually.
🚭 HIPPODM8CP001h — Smoking Status
Measures:
% of diabetes patients with smoking status recorded within the last 12 months.
✅ In short: record whether the patient is a current smoker, ex-smoker, or never smoked.
👥 HIPPODM8CP002a — Annual Diabetes Review
Measures:
% of diabetes patients with a formal review recorded in the last 12 months.
✅ In short: ensure an annual review is coded as a structured diabetes review, not just opportunistic checks.
🍬 HIPPODM8CP002b — No Review but HbA1c Recorded
Measures:
% of diabetes patients without a recorded review in the last 12 months but with an up-to-date HbA1c result.
✅ In short: highlights patients who have had HbA1c monitoring but no formal diabetes review recorded.
🧩 Summary Table
Indicator | Focus | What It Measures | Timeframe |
HIPPODM8CP001 | All 8 Care Processes | % with all 8 completed | 12 months |
HIPPODM8CP001a–h | Individual processes | HbA1c, BP, Cholesterol, Creatinine, ACR, Foot exam, BMI, Smoking | 12 months |
HIPPODM8CP002a | Review | Annual diabetes review completed | 12 months |
HIPPODM8CP002b | HbA1c without review | HbA1c done but review missing | 12 months |
🌟 Why This Matters
Following these indicators helps practices:
Ensure every diabetes patient receives all 8 NICE-recommended care processes.
Track gaps automatically for proactive recall and review.
Improve QOF performance and reduce the risk of diabetic complications.
Support equitable, evidence-based diabetes care across the practice population.
✅ In short: the Hippo Diabetes Indicators align directly with the NICE 8 Care Processes — helping practices deliver complete, high-quality diabetes care and identify who still needs review.
📚 Sources
NICE NG17: Type 1 diabetes in adults
NICE NG28: Type 2 diabetes in adults
NHS England – 8 Care Processes for Diabetes