Reviewed for QOF 2026/27.
Clinical pharmacists can support medicines-related QOF work through patient reviews, appropriate treatment, accurate records and follow-up. The purpose is to deliver good care and record it correctly; points and income depend on the requirements of each indicator.
What pharmacists can contribute
The agreed service may include cardiovascular medicines reviews, diabetes and respiratory care, monitoring, register searches and recall. Each activity must match the clinician’s competence and the practice pathway. Investigations or physical assessments that cannot be completed remotely need an appropriate local arrangement.
QOF indicators change. Use the current NHS England guidance and business rules to establish eligible patients, treatment or measurement requirements, time windows and codes. General medicines-safety measures, such as prescribing audits, should not automatically be described as QOF indicators.
Where clinical care and achievement align
Pharmacists can identify people who may benefit from a review, discuss medicines with them and help complete appropriate actions. For example, an anticoagulation review considers the individual’s stroke and bleeding risks, suitability and preferences. Blood pressure management uses current guidance and individual circumstances rather than a single target for every patient.
Monitoring and record review can identify matters needing further clinical assessment. A register or search result is a starting point for review, not an instruction to prescribe or change a diagnosis automatically.
Examples for QOF 2026/27
- For HYP010/HYP011 (hypertension) and CD001/CD002 (CHD, stroke or TIA), the recorded blood-pressure thresholds are 140/90 mmHg or less at age 79 or under and 150/90 mmHg or less at age 80 or over, excluding moderate or severe frailty. Equivalent home readings and the full indicator rules apply.
- DM037 covers all eight diabetes care processes in the preceding 12 months, including foot examination and urine albumin:creatinine ratio testing.
- Use the relevant severe mental illness register and indicator criteria for physical-health checks; an antipsychotic prescription alone does not establish QOF eligibility.
- AF008 concerns patients on the AF register with CHA2DS2-VASc of 2 or more who receive a DOAC or, where a DOAC is declined or unsuitable, a vitamin K antagonist.
These are summaries of selected indicators, not treatment instructions. Apply the full current guidance, including time windows, coding, exclusions and personalised care adjustments.
Use personalised care adjustments appropriately
Personalised care adjustments recognise specified circumstances in which an indicator should not apply. They must follow the current rules and the patient’s circumstances, with the reason accurately documented. They should not be used simply to improve reported achievement.
Good clinical documentation supports continuity and verification. Adding a code without delivering the corresponding care does not create a valid clinical review.
A practical review cycle
- Agree the relevant indicators, baseline and patient priorities.
- Check register accuracy and identify outstanding clinical work.
- Arrange reviews, tests or other care according to need and accessibility requirements.
- Record the assessment, patient decisions, actions and follow-up.
- Review progress through the year, including unresolved actions and patients who have not attended.
The timetable should fit the indicator rules and clinical need. Urgent care should not wait for an income-reporting deadline, and a year-end search should not be the first review of a known safety concern.
Measure the result
Report care delivered, outstanding work and valid indicator achievement separately. There is no supported universal number of indicators a pharmacist will improve or guaranteed financial return. Where a practice reports an improvement, define the period, cohort, baseline and contribution of the wider team.
Where to start
Agree a defined medicines-related QOF brief with your clinical lead. Our quality and audit services can support agreed review, search and improvement work. Contact us to discuss your priorities.
Primary references
NHS England QOF guidance for 2026/27; NICE NG5 medicines optimisation.
Frequently asked questions
Does any medication review earn QOF points?
No. Achievement depends on the current indicator’s population, activity, timing and coding rules. A general medication review or prescribing audit is not automatically a QOF achievement.
Can pharmacists help improve QOF performance?
They can support agreed medicines-related reviews, appropriate treatment, searches, recall and accurate recording. Outcomes depend on clinical need and coordinated delivery by the practice team.
How should personalised care adjustments be used?
Apply the current rules to the patient’s circumstances and document the reason. They should not be used simply to improve reported achievement.
Can a fixed income increase be guaranteed?
No. Review the practice baseline, current indicators and work delivered. Any numerical improvement claim needs a defined period, cohort and evidence.
