QOF 2025/26: Key Strategies for Cardiovascular Disease Prevention
- Mohammed A Rashad
- 4 days ago
- 5 min read
One in four deaths in the UK is caused by cardiovascular disease, a figure that continues to challenge the NHS and primary care teams every single day. This year, the stakes have been raised even higher: the 2025/26 Quality and Outcomes Framework (QOF) has shifted 141 points—nearly a quarter of the entire QOF total—directly into cardiovascular disease prevention, with the government aiming to cut premature deaths from heart disease and stroke by 25% within the next decade.
The message is clear: CVD prevention is no longer just a clinical priority, but a contractual and financial one too, reshaping the landscape for every practice in the country.
This is not simply a matter of ticking boxes or chasing targets. The new QOF indicators demand a more ambitious, data-driven, and patient-centred approach to blood pressure and cholesterol management than ever before. For practices ready to adapt, this is a rare opportunity to transform outcomes, secure vital funding, and lead the way in tackling the UK’s biggest killer.
Let’s explore the key strategies that will help your team not just meet, but exceed, the new standards for cardiovascular disease prevention.
Key Takeaways
Why the Focus on CVD Prevention?
Cardiovascular disease (CVD) remains the leading cause of premature death in the UK, responsible for over 25% of all fatalities. The NHS has responded with a bold shift in the 2025/26 Quality and Outcomes Framework (QOF), reallocating 141 points—nearly a quarter of the total QOF points—directly to CVD prevention.
This is not just a policy change; it is a call to action for every practice to deliver measurable improvements in blood pressure and cholesterol management, with the government targeting a 25% reduction in premature deaths from heart disease and stroke within a decade.
The 2025/26 QOF CVD Indicators
The Nine Key CVD Indicators
The 2025/26 QOF contract has concentrated its CVD focus into nine high-impact indicators, each with ambitious new thresholds and increased points. These indicators cover:
Statin prescribing for CVD/CKD (CHOL003): 70–95% threshold, 38 points.
Cholesterol control in established CVD (CHOL004): 20–50% threshold, 44 points.
Blood pressure control in hypertension under 80 (HYP008): 40–85% threshold, 38 points.
Blood pressure control in hypertension 80 and over (HYP009): 40–85% threshold, 14 points.
Blood pressure control in CHD under 80 (CHD015): 40–90% threshold, 33 points.
Blood pressure control in CHD 80 and over (CHD016): 46–90% threshold, 14 points.
Blood pressure control in stroke/TIA under 80 (STIA014): 40–90% threshold, 8 points.
Blood pressure control in stroke/TIA 80 and over (STIA015): 46–90% threshold, 6 points.
Blood pressure control in diabetes under 80 without frailty (DM036): 38–90% threshold, 27 points.
These indicators demand near-universal coverage or robust exception coding, with upper thresholds now set at 85–90% for most measures.
What’s Changed?
Higher thresholds: Practices must now achieve tighter control for more patients to earn maximum points.
Increased points: The reward for meeting these targets is significantly higher, making CVD prevention a major driver of QOF income.
Outcome focus: There is a shift from process-based to outcome-based indicators, especially for cholesterol and blood pressure.
Practical Steps for Meeting the New CVD Indicators
1. Early Identification and Recall
Run regular searches in your clinical system to identify patients not meeting blood pressure or cholesterol targets.
Prioritise recalls for those closest to target, as small adjustments can yield significant QOF gains.
Use digital reminders and automated recall systems to ensure no patient is missed.
2. Clinical Audits and Data-Driven Action
Audit your registers for hypertension, CHD, stroke/TIA, diabetes, and CKD to ensure all eligible patients are included and coded correctly.
Monitor QOF dashboards (e.g., in EMIS Web or SystmOne) to track progress and identify gaps.
Stratify patients by risk and likelihood of achieving targets, focusing resources where they will have the most impact.
3. Staff Training and Team-Based Care
Train all clinical staff on the new QOF CVD indicators, exception reporting, and the importance of accurate coding.
Empower pharmacists and nurses to run medication reviews, titrate antihypertensives, and support statin optimisation.
Hold regular team meetings to review progress, share best practice, and troubleshoot barriers.
4. Patient Engagement and Education
Educate patients about the importance of blood pressure and cholesterol control, using leaflets, digital resources, and one-to-one discussions.
Promote lifestyle interventions alongside medication, including diet, exercise, smoking cessation, and alcohol moderation.
Use shared decision-making to improve adherence, especially for statins and antihypertensives.
5. Coding and Documentation
Ensure accurate coding for diagnoses, medication exceptions, and patient refusals. For example, use “statin declined” or “lipid-lowering therapy unsuitable” codes where appropriate.
Document all interventions and patient contacts, as this supports exception reporting and QOF validation.
Review exception rates regularly to ensure they are justified and not excessive, as high rates may trigger scrutiny.
Overcoming Common Challenges
Managing Statin Refusals and Contraindications
Offer alternatives such as ezetimibe or PCSK9 inhibitors if statins are not tolerated, and code these appropriately.
Document informed dissent clearly, ensuring patients understand the benefits and risks.
Achieving Tight Cholesterol and Blood Pressure Targets
Optimise medication regimens with regular reviews and titration.
Encourage home blood pressure monitoring to capture true control, especially for patients with white coat hypertension.
Schedule follow-up blood tests at 3 and 12 months after medication changes to track progress.
Exception Reporting
Use exception reporting judiciously for patients who cannot achieve targets due to clinical reasons or informed dissent.
Invite patients for review at least twice before exception coding for non-attendance, as per QOF rules.
Keep exception rates under review to avoid overuse and ensure compliance with QOF guidance.
The Medicines Management Team (TMMT) Support
How TMMT Can Help Your Practice
Expert audits: TMMT can review your practice’s CVD registers, coding, and QOF achievement to identify opportunities for improvement.
Staff training: We offer tailored training sessions on QOF indicators, medicines optimisation, and patient engagement.
Patient engagement resources: Access our suite of patient education materials and digital tools to boost uptake of CVD prevention services.
Ongoing support: Our team is available for advice, troubleshooting, and hands-on support throughout the QOF year.
Conclusion
The 2025/26 QOF changes represent a transformative opportunity for primary care to lead the fight against cardiovascular disease. By focusing on early identification, robust clinical management, and patient-centred care, practices can not only secure vital funding but also deliver life-changing outcomes for their communities. With the right strategies and support, your team can rise to the challenge and set a new standard for CVD prevention in the UK.
To find out how The Medicines Management Team can help your practice excel in CVD prevention and QOF achievement, contact us today for a free consultation.
FAQs
What does QOF mean in medical terms?
QOF stands for the Quality and Outcomes Framework. It is a voluntary annual reward and incentive programme for GP practices in England, designed to improve the quality of care by measuring achievement against a set of clinical and public health indicators. Practices earn points and funding based on their performance in areas such as chronic disease management and prevention.
What does CVD stand for?
What is a CVD risk assessment?
What is the NHS CVD strategy?
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