💰 Start with your highest-value, time-sensitive indicators
Some indicators have hard timeframes built into the business rules, meaning there's a clinical or contractual deadline, not just an annual review window. These are worth prioritising first, particularly for newly diagnosed or newly registered patients.
Prioritise indicators with the highest upper thresholds. Indicators requiring 85–90% achievement leave little room for error. The more time you have to identify, contact, and follow up with patients, the better your chances of reaching those targets. If you only have capacity to set up a handful of campaigns over the coming weeks, start with the ones where the bar is highest.
💊 Diabetes (DM), hypertension (BP) and cardiovascular disease (CD): start early
These are the bread-and-butter QOF domains: large registers, lots of reviewable patients, and consistently high point values year on year. Recalling eligible patients early, while there's still time for medication changes and follow-up appointments, is one of the highest-return actions you can take right now.
🌬️ COPD and asthma reviews: spread the load
Annual reviews for respiratory patients are a classic Q3/Q4 bottleneck. Starting recall now means you can work through your register steadily rather than cramming it into February and March.
💉Immunisations: now is the time to catch up
Childhood vaccination rates in England are well below the 95% WHO target needed to prevent outbreaks. In 2024, England recorded over 2,900 confirmed measles cases and the UK lost its WHO measles elimination status as a result. The government launched a national 'Stay Strong, Get Vaccinated' campaign in February 2026 to address this.
For your practice, this means:
Check for children with incomplete schedules - particularly for MMR/MMRV, which is now given as a 4-in-1 vaccine (measles, mumps, rubella, and chickenpox) following the schedule change in January 2026. The second dose has moved forward to 18 months.
Pertussis (whooping cough) - ensure pregnant patients are being offered vaccination. Coverage for Q1 2025/26 was 71.2%, a significant improvement on the previous year, but with over a quarter of eligible patients still unvaccinated there is meaningful ground to make up.
Use your recall campaigns to prompt parents - a message that references the current context ("Measles cases are rising in the UK: is your child's vaccination up to date?") is more likely to prompt action than a routine reminder.
📫Rethink your messaging, not just your volume
Case Study: Cervical Smears
Nationally, less than 70% of eligible people aged 25–64 were adequately screened in 2023/24, and coverage is lowest in the 25–49 age group (66%), exactly the cohort hardest to engage through traditional letter-based recall.
Engagement on cervical screening responds more to how you communicate than how often. A few ideas:
Include a link to NHS guidance on preparing for a smear test, or support for anxious patients in your invite message. Anxiety about the procedure is one of the most cited reasons for non-attendance.
Proactively mention in your message that the practice can accommodate adjustments, such as seeing a female clinician, taking extra time, or what you can do to make the procedure easier.
Consider whether your messaging encourages patients to call and book, or whether they can use an online booking link.
Layer your messages with statistics rather than sending the same message three times, reinforce how important these screenings are. Some ideas:
Message 1: Cervical screening can feel daunting, but we want to make it as easy as possible for you. Appointments usually take around 15–20 minutes, and you can request a female clinician, a longer appointment, or just a chat with a nurse beforehand. If you would like to discuss adjustments, please call the surgery and we can get you booked in, or use the booking link below.
Message 2: Cervical screening finds cell changes before they become cancer, making treatment simpler, and outcomes are far better. The HPV vaccine has already reduced cervical cancer rates by 90% in England. and most patients only need to be screened every 3-5 years.
Message 3: Without regular screening, cervical cancer can develop without any symptoms until it's advanced. Around 3,300 people are diagnosed in England each year, but most cases are preventable. If you have any worries about the appointment, please give us a call and we will be happy to talk through the procedure and how we can make it as quick and comfortable as possible.
Use social norms framing to make attendance feel like the expected, normal thing to do. Rather than focusing on why patients haven't attended, lead with what the majority of their peers are doing.
For cervical screening, this might look like: "Most women registered at this practice are up to date with their cervical screening" - straightforward, locally credible, and quietly corrective for those who assume non-attendance is common. Avoid framing that inadvertently signals the opposite (e.g. "Many of our patients have not yet booked" reinforces the wrong norm). If your practice has strong local uptake data, use it - a local figure will land harder than a national one.
For more ideas on social norms framing, take a look at the NSNC guidance.
📈 Know which indicators have changed before you set your priorities
The proposed 2026 QOF business rules are now available and all changes can be seen here. This year only one threshold has increased: the upper threshold for AF006 is now 95% (up from 90% last year), and a number of new indicators have been added.
🧪 These are still being tested; once they are confirmed, the amended indicators will be made available on Hippo. In the meantime, you can continue to run your usual searches, and the new indicators/updates will be implemented soon.
QOF point values and upper thresholds shift every year, and campaigns that weren't a top priority last year can become high-value overnight.
To illustrate why this matters: in 2025/26, NHS England redirected 141 QOF points (worth approximately £198m nationally) into cardiovascular disease prevention, raising upper achievement thresholds across BP and cholesterol indicators. Maximum points for hypertension (HYP008) required 85% of under-80s controlled (up from 77%), and 90% control was needed across CHD, stroke, and diabetes groups for full points. Practices that didn't adjust their campaign priorities early in the year felt that acutely by Q4.
The same logic applies every year. Identify what's changed, then recall your eligible patients early, while there's still time for medication changes and follow-up appointments.
🛟 Need help setting up your campaigns, or want to review your current messaging? Drop us a message via the chat, or email [email protected] to speak to the Customer Success Team.