Changes to the ‘COPD Register’ QoF Code Cluster in SystmOne

There have been some recent updates made to the COPD QoF business rules which affect how the COPD QoF register is defined.

Key changes include:

1. Changes to diagnostic coding inclusion
   Some codes that were previously included in the COPD register are no longer counted. Examples include:
   • Exacerbation of COPD codes
   • Chronic bronchitis codes
   • Some emphysema codes
2. Newly included codes
   Two additional codes are now included:
   • COPD causing sleep disturbance
   • COPD not causing sleep disturbance
3. Inclusion based on process codes
   Patients will now be added to the COPD QoF register if certain COPD-related process codes have been recorded within the last two years. These include:
   • Selected COPD review codes (e.g. COPD annual review)
   • Selected COPD review invitation codes (e.g. COPD monitoring invitation)

These changes mean that the composition of the COPD QoF register may shift, with some patients no longer included and others being newly identified based on the updated criteria.

We have engaged with NHS England to seek clarification and have provided feedback on these changes; however, they will remain in place despite the concerns raised.

To support practices in managing this transition, CDRC have developed the following resources:

1. CDRC COPD Alerts and Recalls

From 1 August 2026, CDRC functions (including LTC recall systems and quality control/safety reports) will align with the updated QoF COPD diagnosis codes as the basis for the CDRC COPD register.

Patients included solely due to process codes (e.g. review codes) will not be classified as having COPD within the CDRC register.

To ensure consistency and data quality, it is recommended that the following quality control searches are completed before the end of July.

2. CDRC Quality Control Reports

The following reports are available on SystmOne within the CDRC Quality > Respiratory Folder

here have been some unusual changes to the COPD QoF business rules affecting the COPD QoF register.

* The most sensible code to use is Chronic obstructive pulmonary disease 13645005 (CTV H3)

The COPD Diagnosis visualisation can support this review process by bringing together key clinical information from the patient record, including spirometry results and relevant diagnostic and activity codes.

The example below shows a patient who was previously included on the COPD register due to a chronic bronchitis code. Under the updated rules, the patient now appears on the register only because a COPD review or invitation has been recorded within the last two years. In such cases, this patient will be removed from the register if further reviews or invitations are not recorded.

3.  Coding Protocols

Two new automatic protocols are available to help prevent inappropriate coding:

1. Legacy Diagnosis Code Alert
   1. A protocol to alert the user when a legacy COPD diagnosis code (e.g exacerbation of COPD) is entered for a patient who does not have a COPD diagnosis code included in the updated QoF list.
2. Review/Invitation Code Alert
   1. A protocol to alert the user when a COPD review / invitation code (e.g COPD annual review) is recorded for a patient who does not have a COPD diagnostic code in the updated QoF list.

To activate these protocols, you must have CDRC Respiratory resources activated.  You can check this by running the Customisation – Respiratory – Units Activated report. If this report returns a number similar to your practice list size, the resources are activated. 

If you would like them activated contact contact-cdrc@healthinnovationnenc.org.uk

Thank you

CDRC