❓FAQs

Does a new qualifying BMI restart the 90-day referral window?

Recording a new qualifying BMI during the QOF year starts a new 90-day referral window. If the original 90-day period was missed, a new qualifying BMI allows another opportunity to make the referral within the required timeframe.

If a patient has already been referred, do they need another referral if a new BMI is recorded?

No. Once an appropriate referral has been recorded within 90 days of a qualifying BMI, the patient is counted as complete for QOF OB004 for the remainder of the QOF year. They do not need to be referred again simply because another BMI is recorded.

Which referral codes count towards OB004?

The QOF business rules recognise the following referral codes:

• Referral to Weight Management Service

• Referral to NHS Digital Weight Management Programme

• Referral to Local Authority Weight Management Programme

• Referral to NHS Diabetes Prevention Programme (where appropriate)

• Referral to Total Diet Replacement Programme

These are included within the Ardens templates.

Does advice alone count, or does there have to be a referral?

A referral must be recorded. Advice or lifestyle counselling alone does not achieve the OB004 indicator.

What should we do for patients already using private weight loss medication?

If private weight loss medication is recorded in the patient's medical record, this should remove them from the OB005 denominator where appropriate. For OB004, referral should still be offered if clinically appropriate. If the patient declines because they are already receiving private treatment, record the decline in their medical record.

If a patient declines referral or doesn't respond to invitations, do we keep inviting them?

No. A recorded decline only needs to be entered once. Personalised Care Adjustment (PCA) invitation codes are also available where patients do not respond following the appropriate invitation process.

Does the patient need an obesity diagnosis code to qualify?

No. Eligibility for the obesity indicators is based on BMI and the QOF criteria. A diagnosis code for obesity is not required.

Why do my Ardens searches show different patient numbers (Outstanding, Time Sensitive and Manager)?

The searches have different purposes:

• Outstanding shows all eligible patients who may still require work.

• Time Sensitive shows patients whose 90-day referral window is approaching expiry.

• Ardens Manager reflects overall QOF achievement, so the numbers will not necessarily match.

Can OB004 and OB005 be completed at the same consultation?

Yes. There is no requirement to wait until a referral has been accepted or completed. If all relevant discussions have taken place and the appropriate coding has been recorded, both indicators can be completed during the same consultation where appropriate.

Which weight management service should patients be referred to?

Practices should follow their local referral pathway. Depending on local commissioning arrangements, this may include the NHS Digital Weight Management Programme, Local Authority Weight Management Services, or other commissioned services. Where the local pathway is patient self-referral, recording the referral when directing the patient to self-refer is considered appropriate.

If a patient's BMI later falls below the referral threshold, can the be exception coded for OB004?

A subsequent lower BMI does not remove the qualifying BMI that triggered the indicator.

For OB004, a valid weight management referral (or an appropriate exception, where applicable) should be recorded within 90 days of the qualifying BMI. Practices should apply the QOF business rules based on the patient's clinical circumstances and use their clinical judgement when determining whether exception coding is appropriate.