Guide: QOF

Maximising income from QOF: Peripheral Arterial Disease

Updated November 2022

Summary – indicators and value

Indicators: 1
Points: 2
Prevalence*: 0.6%
£/patient on the register (est.): £7.50

*Prevalence is an estimate based on latest available QOF data and current trends. For further explanation read more details here.

Background

Peripheral arterial disease (PAD) has only been part of the QOF for five years. The prevalence has been falling slowly over that time, presumably due to improvements in the management of risk factors, such as diabetes and smoking.

Patients with PAD are likely to have other arterial conditions such as heart disease or stroke. For this reason, all of the indicators other than the register itself were removed in 2019/20.

Indicator 1: Maintain patient register (2 points)

Coding PAD, including intermittent claudication, will qualify a patient for the register. There is no code to remove a patient from the register – clinically this is not a condition that would be expected to resolve, although improvement is achievable.

There are not really any specific patterns of prescribing that would easily identify patients that might be missing a diagnostic code. However, these patients are likely to have other vascular disease or diabetes. Patients with diabetes who have had poor foot pulses noted on their annual check should be considered for further investigation, and therefore possible PAD.

While there are no lab tests that would identify PAD, searching for Doppler test results can identify patients who have not had a diagnostic code for PAD. This is considerably easier if Doppler results are entered using a template with appropriate codes.

Removed in 2019/20:

There are no longer indicators for blood pressure control and being prescribed aspirin or other anti-platelet agent. They are important clinically and will continue to be monitored outside the QOF.