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QOF accepted code changes

Interface have become aware of changes made by NHS digital around QOF accepted read codes for the 20/21 QOF year.

Interface‘s Technical team are available to provide advice and answer any questions around the code changes introduced. We are also able to produce a free QOF Health Check to measure current register sizes and identify areas for potential improvement ahead of the year close in March.

Interface can also provide comprehensive support to increase practice prevalence, and by extension, QOF income for the 20/21 year. This additional funding can then be reinvested within the practice. PCN/CCG wide projects can be delivered for widespread register maintenance and growth.


These changes include the removal of ‘Pathological fracture due to osteoporosis (fragility fracture due to unspecified osteoporosis)’ and is therefore no longer recognised for QOF register inclusion. We are aware that this is a particularly prominent code used throughout primary care to help manage and register osteoporotic patients. As such, a large number of patients will now not be on practice registers.

Osteoporotic patients within the 50-74 year grouping will now require three separate codes for register addition while those aged 75+ will require two separate codes for inclusion.

Domains such as Cancer, Diabetes and COPD have also had previously accepted codes removed from the approved list which will have resulted in patients falling off practice registers. Practices are urged to check their disease registers for patients suffering with Osteoporosis, Cancer, Diabetes and COPD in particular.


Although the NHS have issued guidance around QOF to help prioritise COVID vaccinations stating that income will be protected, this does not account for register inclusion changes.

Points 6 and 7 within the communication sent to practices on the 7th of January 2021 describe the changes introduced affecting QOF for the 20/21 year.

6. The Quality Improvement domain within QOF will be protected in full at 74 points per practice until March 2021.

7. The 8 prescribing indicators within QOF will be income protected on the same basis as the existing 310 points which have been income protected. Payment will be made on past performance against the relevant clinical domains. We will use the 20/21 recorded register size to apply the usual prevalence adjustment as well as the usual list size adjustment to 20/21 QOF payments.

As stated, QOF points will be protected but 20/21 disease prevalence will be used for the payment adjustment. With the code changes and expected high volumes of patient fall-off, payments will be below expectations if no prior action is taken.

QOF Disease Prevalence Coding Support

Our Clinical Pharmacists are now able to offer coding support across a number of QOF domains

Find out more