Maximising your QOF income: Obesity

Weight management enhanced service
  • Indicators: 1
  • Points: 8
  • Prevalence (2016-17): 7.5%
  • £/patient on the register (est.): £2.35

The obesity area has only ever had a single indicator, which awards full points for keeping the patient register up-to-date.

Indicator 1: Maintain patient register (8 points)

The register consists of all patients over 16 years of age with a body mass index (BMI) of 30 or greater recorded during the QOF year.

The codes which put patients onto the register include a BMI result, but also codes which refer to a high BMI in the text. These latter codes can be used if a patient obviously has a BMI of over 30 or 40, but recording an actual weight is impractical.

Tips to boost prevalence

The relatively low reimbursement available for putting a patient onto the register probably does not warrant a recall system, but there are other techniques which can increase your prevalence figures.

For instance, whenever a weight is measured, then a BMI should also be calculated. This can be an easy step to miss. It is very simple (though also time-consuming) to search for patients with a recorded weight but no BMI in the current year.

Recording BMI should be part of the annual reviews for most chronic diseases. Although the previous specific indicators for patients with diabetes or mental health problems no longer exist they remain a high risk group and should have their weight measured annually.

In my practice, I find it useful to set a reminder for clinicians to check patients’ BMI. It is not always very obvious without a specific search to see if a measurement of weight has already been made and the BMI calculated. A simple alert for patients with a previously high BMI, but no current reading, significantly increased our recording rate.

As this is purely a register there is no need for exception reporting (or ‘personalised care adjustment’, as now termed).

For reference:

Indicator 1: The contractor establishes and maintains a register of patients aged 18 years or over with a BMI ≥30 in the preceding 12 months (OB002)

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