The QOF Business Rules v45.0 are now published and we have updated the Ardens SystmOne QOF templates. Below is a summary of the changes, along with some outstanding comments that we have fed back to the NHS England QOF team. Please also see our PCN DES 2020/21 Support Article.

Please also see the following QOF Support Articles:


New Indicators


Diagnosis - Spirometry and FeNO or PEFR variability 3m before to 6m after

Review - Asthma review, ACT, number of exacerbations, inhaler technique and care plan

Review - Smoking exposure in young people <19y including passive smoking


Diagnosis - FEV1/FVC ratio 3m before to 6m after

Review – Number of exacerbations


Heart Failure

Review - Functional assessment and medication optimisation


Non-Diabetic Hyperglycaemia

Review - Annual HbA1c


New Quality Improvement

Reports and resources have also been built to assist with the NHS England QOF QI.

Early Cancer Diagnosis

QI005: Quality Improvement Activity focused on early cancer diagnosis

QI006: Network activity and peer review meetings


  • Cancer screening uptake for bowel, breast and cervical screening
  • Fast track referrals guidelines and safety netting


Go to Clinical Reporting > Ardens > Conditions | Cancer

Go to Clinical Reporting > Ardens > Contracts | PCN DES

For safety netting, please see this Support Article 


Learning Disability

QI007: Quality Improvement Activity focused on Learning Disability

QI008: Network activity and peer review meetings


  • Register Accuracy
  • Annual Health Check Uptake
  • Medication Optimisation + STOMP initiative
  • Reasonable Adjustments (no SNOMED-CT code exists for this)
  • Engagement with local services and population

Go to Clinical Reporting > Ardens > Conditions | Mental Health

For the Learning Disability template, please see this Support Article

Outstanding Comments

We have a number of outstanding comments and requests with regards to some of the indicators on the QOF Business Rules v45.0 that we have raised with the NHS England QOF Team. We will therefore potentially be making further updates once we hear their response.

AST007 - Dates

The criteria states that the asthma review, ACT score, number of exacerbations and care plan have to be recorded on the same date. We don’t think this is appropriate as often then the ACT score is done first along with recording the number of exacerbations via a patient questionnaire or by the HCA. The review and care plan are then often completed at a later date

Request: Remove same date requirement




AST007 - Description 

The description mentions an ‘assessment of inhaler technique’ but not code’s mentioned.

Request: Remove ‘assessment of inhaler technique’ from the description (or codes added if this is needed).


A screenshot of a cell phone

Description automatically generated


AST007 - Care Plan Codes

There are a couple of care plan codes which we believe should be included

Request: Add the following codes into the WRITPASTP cluster

                - Asthma management plan given 406162001

                - Asthma self-management plan agreed 811921000000103



AST008 – Passive smoker

There isn’t an option to record ‘not a passive smoker’

Request: Add ‘Not a passive smoker 315213009’ to the SMOKEXPO cluster



HF007 - Description

The description mentions ‘assessment of functional capacity’ but no codes are mentioned.

Request: Removed ‘assessment of functional capacity’ from description (or add required codes, e.g. NYHA)




HF007 – Medication Review

There are a number of codes that would be useful to add to this cluster

Request: Add the following codes to either the HFMEDRVW or MEDRVW cluster


Cardiac medication review


Optimisation of drug dosage


Medication satisfactory


Medication changed


Medication decreased 


Medication increased 


Medication stopped - side effect


Medication stopped - ineffective


Medication stopped - interaction


Medication stopped - contra-indication




NDH001 – Diagnosis resolved codes

If a patient has been previously diagnosed with NDH/Pre-DM, if their condition then resolves due to a number of years with a normal HbA1c, they should be removed from the register to avoid being recalled inappropriately for an annual HbA1c. This has been an issue for some time, but now as this is a QOF indicator then not only will it have an impact on the patient but will also negatively impact a practice’s QOF points for this indicator.

Request: Please can you consider adding a ‘non-diabetic hyperglycaemia resolved’ and a ‘pre-diabetes resolved’ code to the exclude patients from the NDH register. I’m unaware of a code that exists for this at present, so a new SNOMED-CT code may need to be requested for this.