QOF

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Patient Population

With co-morbidity of coronary heart disease, PAD, stroke or TIA, hypertension, diabetes aged 17 or over, COPD, CKD and aged 18 or over, Asthma aged 20 and over, schizophrenia, bipolar affective disorder or other psychoses.

(Note: A patient need only qualify for ONE of the disease areas to be included in the patient population)

Smoking status added in the preceding 12 months and they must be recorded after any new diagnosis

Smoking codes

137.. Tobacco consumption
1372. Trivial smoker - <1 cig/day
1373. Light smoker - 1-9 cigs/day
1374. Moderate smoker - 10-19 cigs/day
1375. Heavy smoker - 20-39 cigs/day
1376. Very heavy smoker - 40+ cigs/day
1377. Ex-trivial smoker (<1/day)
1378. Ex-light smoker (1-9/day)
1379. Ex-moderate smoker (10-19/day)
137A. Ex-heavy smoker (20-39/day)
137B. Ex-very heavy smoker (40+/day)
137C. Keeps trying to stop smoking
137D. Admitted tobacco cons untrue?
137F. Ex-smoker - amount unknown
137G. Trying to give up smoking
137H. Pipe smoker
137J. Cigar smoker
137K. Stopped smoking
137M. Rolls own cigarettes
137N. Ex pipe smoker
137O. Ex cigar smoker
137P. Cigarette smoker
137Q. Smoking started
137R. Current smoker
137S. Ex smoker
137T. Date ceased smoking
137V. Smoking reduced
137X. Cigarette consumption
137Y. Cigar consumption
137Z. Tobacco consumption NOS
137a. Pipe tobacco consumption
137b. Ready to stop smoking
137c. Thinking about stopping smoking
137d. Not interested in stopping smoking
137e. Smoking restarted
137f. Reason for restarting smoking
137g. Cigarette pack-years (v28)
137h. Minutes from waking to first tobacco consumption
137j. Ex-cigarette smoker
137l. Ex roll-up cigarette smoker
137m. Failed attempt to stop smoking
137n. Total time smoked (v28)
137o. Waterpipe tobacco consumption
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Current Smoker Codes - recorded in the last 12 months

137.. Tobacco consumption (v28)
1372. Trivial smoker - <1 cig/day
1373. Light smoker - 1-9 cigs/day
1374. Moderate smoker - 10-19 cigs/day
1375. Heavy smoker - 20-39 cigs/day
1376. Very heavy smoker - 40+ cigs/day
137C. Keeps trying to stop smoking
137D. Admitted tobacco cons untrue?
137G. Trying to give up smoking
137H. Pipe smoker
137J. Cigar smoker
137M. Rolls own cigarettes
137P. Cigarette smoker
137Q. Smoking started
137R. Current smoker
137V. Smoking reduced
137X. Cigarette consumption
137Y. Cigar consumption
137Z. Tobacco consumption NOS
137a. Pipe tobacco consumption
137b. Ready to stop smoking
137c. Thinking about stopping smoking
137d. Not interested in stopping smoking
137e. Smoking restarted
137f. Reason for restarting smoking
137h. Minutes from waking to first tobacco consumption
137m. Failed attempt to stop smoking
137o. Waterpipe tobacco consumption

Or never smoked tobacco - Recorded after diagnosis, and if under the age of 26 within the last 12 months, or if aged 25 or over just one recording is required after their 25th birthday.

1371. Never smoked tobacco

Or Ex-Smoker recorded within the last 12 months.
(Once this has been recorded on three consecutive years it is not required again unless they start smoking)

1377. Ex-trivial smoker (<1/day)
1378. Ex-light smoker (1-9/day)
1379. Ex-moderate smoker (10-19/day)
137A. Ex-heavy smoker (20-39/day)
137B. Ex-very heavy smoker (40+/day)
137F. Ex-smoker - amount unknown
137K. Stopped smoking
137N. Ex pipe smoker
137O. Ex cigar smoker
137S. Ex smoker
137T. Date ceased smoking
137j. Ex-cigarette smoker (v15)
137l. Ex roll-up cigarette smoker (v16)

Exclusions

9hG1. Excepted from smoking quality indicators: Informed dissent
9hG0. Excepted from smoking quality indicators: Patient unsuitable
137k. Refusal to give smoking status
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SMOK 002.1- Rationale

See SMOK004.1 AND SMOK005.1

SMOK 002.2 Reporting and verification

See indicator wording for requirement criteria. The contractor should report smoking status using the following guidance:

Smokers

For patients who smoke, smoking status should be recorded in the preceding 12 months.

Non-smokers.

It is recognised that life-long non-smokers are very unlikely to start smoking and repeatedly asking smoking status can be unnecessary. Smoking status for this group of patients should be recorded in the preceding 12 months for until the end of the financial year in which the patient reaches the age of 25.

Once a patient is over the age of 25 years (e.g. in the financial year in which they reach the age of 26 or in any year following that financial year) to be classified as a non-smoker they should be recorded as:

Ex-smokers.

Ex-smokers can be recorded as such in the preceding 12 months for SMOK002. Practices may choose to record ex-smoking status on an annual basis for three consecutive financial years and after that smoking status need only be recorded if there is a change. This is to recognise that once a patient has been an ex-smoker for more than three years they are unlikely to restart.

For the purposes of QOF users of electronic cigarettes who have never smoked or given up smoking should be classified as non-smokers or ex-smokers respectively.

The disease register for the purpose of calculating APDF for SMOK002 and SMOK005 is defined as the sum of the number of patients on the disease registers for each of the conditions listed in the indicator wording. Patients with one or more comorbidities e.g. diabetes and CHD are only counted once.

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Prepared By Jean Keenan