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    Consultation on new and updated NICE indicators: GID-IND10330 to GID-IND10335 & GID-IND10337 to GID-IND10338

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    Heart failure: ejection fraction category (newly diagnosed)

    GID-IND10327: The percentage of patients with a diagnosis of heart failure on or after 1st April 2026 who have a recorded ejection fraction category (reduced, mildly reduced, or preserved).

    Indicator type

    General practice indicator suitable for use in the QOF.

    Rationale

    The recording of heart failure (HF) ejection fraction category (reduced, mildly reduced, or preserved) appears to be suboptimal in primary care records, contributing to disparities in treatment and poorer patient outcomes. The lack of precise phenotype classification can result in inconsistent and suboptimal care, through both under and overtreatment. Improving the routine coding of heart failure type in general practice electronic medical records (EMRs) presents an opportunity to refine care pathways and improve care outcomes.

    Studies by Bellanca et al (2023), Nakao et al (2023) and Sundaram et al (2022) report a recording of heart failure subtype in general practice between 13% and 26%. Testing by NICE in June 2025 of CPRD Aurum suggests that 42% of all people with heart failure have an ejection fraction category recorded (reduced, mildly reduced or preserved). CPRD Aurum March 2025 (Version 2025.03.001) [Data set]. Clinical Practice Research Datalink. https://doi.org/10.48329/6570-ge08.

    Specification

    Numerator: The number of patients in the denominator who have a recorded ejection fraction category (reduced, mildly reduced, or preserved).

    Denominator: The number of patients newly diagnosed with heart failure on or after 1st April 2026.

    Questions for consultation:

    14. Given the likely under-recording of ejection fraction category for patients with long-standing diagnosed heart failure, is focusing on new diagnoses a pragmatic approach for quality improvement?

    15. Are there specific clinical or practical challenges in the routine recording of ejection fraction category for all patient newly diagnosed with heart failure?