Updated November 2022
*Prevalence is an estimate based on latest available QOF data and current trends. For further explanation read more details here.
Osteoporosis has been part of the QOF for seven years, although it is now purely a register of patients.
This is essentially two registers stuck together. There are different criteria for patients for patients older than 75 and those between 50 and 74.
Patients 50-74 years old
Patients should have had a fragility fracture coded after April 2012. This is not automatic: ultimately it is a clinical decision whether any fracture is due to fragility and it will need to be specifically coded.
Three codes are required:
With these three codes the patient is logged on the register and eligible for treatment.
Patients 75 and older at the end of the QOF year
Things are a little simpler in older patients. The qualifying date is later – they should have had a fragility fracture after April 2014 and again must be specifically coded as a fragility fracture. A proportion of patients will have automatically moved on from the previous part of the register.
While a DEXA scan may be appropriate, there is no requirement for this to happen before they appear on the register. There does, however, need to be a diagnostic code for osteoporosis.
There are several codes to enter and most of the activity occurs in secondary care.
This is easy to get wrong. Having an effective procedure can ensure that patients appear on the register, as follows:
Removed in 2019/20:
The indicators for this area requiring treatment with bone sparing agents were removed. There were concerns about over-treatment and the small numbers of patients involved.
Dr Gavin Jamie is a GP in Swindon and runs the QOF database website
Indicator 1: The contractor establishes and maintains a register of patients:
Aged 50 or over and who have not attained the age of 75 with a record of a fragility fracture on or after 1 April 2012 and a diagnosis of osteoporosis confirmed on DXA scan, and
Aged 75 or over with a record of a fragility fracture on or after 1 April 2014 and a diagnosis of osteoporosis (OST004; 3 points)
Or, please register for a free trial to access all of the guides and unlock all features.