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Patient recall works when the right patient gets the right message at the right time, on a channel they actually read. Most recall problems come from getting one of those three wrong. Here are seven ways to fix them.

What is patient recall?

Patient recall is how your practice invites patients who are due care: an annual review, a blood pressure check, a smear, a vaccination. It covers finding who is due, contacting them, and getting them booked.

Done by hand, it means searches, spreadsheets, letters and phone lists. Done well, it runs every day in the background and your team only handles the patients who need a person.

1. Which channel gets the most patients booked?

The NHS App. Across practices using Hippo, here is how many recalled patients booked within two weeks, by channel:

Channel	Patients who booked
NHS App	44.1%
Email	35.8%
Text (SMS)	30.8%
WhatsApp	26.1%

So if a patient has the NHS App, use it first. Text is still worth sending. It just should not be your only channel.

2. Do you need to pick a channel for every patient?

No. Pick an order and let the system follow it.

Hippo checks four channels for each patient. First it reuses whatever worked last time: if a patient booked from an email before, they get an email again. If there is no history, it tries the NHS App, then email, then WhatsApp, then text. It skips any channel the patient has opted out of.

You stay in control. Each campaign can be limited to the channels you choose.

3. How do you stop recalling the same patients too often?

Set a delay after recent care.

A patient reviewed in February becomes eligible again on 1 April when the QOF year resets. Without a buffer, they get recalled straight away. That annoys patients and wastes appointments.

In Hippo this is the Eligible Delay. It defaults to six months: a patient seen for similar care in the last six months is left out of new campaigns. You can shorten or lengthen it.

4. How many invites should you send per appointment?

More than one, for high-volume clinics.

Not every patient books straight away. If you send one invite per slot for smears or NHS Health Checks, clinics fill slowly. Hippo lets you send several invites per available slot while still respecting your daily cap. Start at one per slot, watch how fast clinics fill, then raise it.

5. How do you reach patients who do not read English?

Send the recall in their language.

Hippo translates recall messages into the preferred language recorded on the patient's record, in more than 70 languages. If no language is recorded, or it is not supported, the patient gets the message in English. It is on by default and you can switch it off per campaign.

Keep preferred language up to date on the record. Translation only works if the field is filled in.

6. How do you keep recall running without someone on it every day?

Automate the routine and keep people for the exceptions.

An automated campaign finds eligible patients, sends invites, and spreads them out so you are not flooded with bookings on Monday morning. Your team then works the patients the automation cannot reach: no contact details, opted out of everything, or needing a conversation.

7. How do you know recall is working?

Measure bookings, not messages sent.

Track how many patients you invited, how many booked, and how long it took. Compare channels against each other. If one condition books far worse than the rest, look at the message and the appointment availability before you send more.

Next steps

If QOF year end is your deadline, read how to hit your QOF targets before 31 March.

To see how Hippo runs recall for your practice, get started or book a demo.

Each QOF indicator has three parts that matter to your team: who is due, what has to be recorded for it to count, and how often it resets. This guide sets those out for the indicators practices ask about most.

Annual indicators reset on 1 April. Anything not recorded by 31 March does not count for that QOF year.

What does "treat to target" mean?

Some indicators need a result, not just an appointment. A treat-to-target indicator only counts when the latest reading is inside the threshold. If the last reading is above it, or there is no reading, the patient stays due.

These take longest to complete, because a patient may need more than one reading. Start them early in the year.

Asthma

Code	What it is	Who is due	What counts as complete	How often
AST007	Annual asthma review	Patients aged 5 and over on the asthma register with no review in the last 12 months	A review with a written personalised action plan on the same day, and an exacerbation count recorded within the month before the review	Annual
AST008	Smoking status, young people with asthma	Patients with asthma aged 19 and under with no smoking status in the last 12 months	Personal smoking status or second-hand smoke exposure recorded	Annual
AST014	Objective testing at diagnosis	Patients diagnosed with asthma on or after 1 April 2025 with no objective test recorded within 3 months either side of diagnosis	An age-appropriate objective test recorded in that window, such as FeNO or spirometry	Once per diagnosis

The asthma review is the indicator most often lost to coding. The action plan has to be recorded on the same day as the review.

Hypertension

Code	What it is	Who is due	What counts as complete	How often
BP002	Blood pressure check	Patients aged 45 and over with no blood pressure recorded in the last 5 years	A blood pressure recorded	Every 5 years
HYP008	Blood pressure control, aged 79 and under	Patients with hypertension aged 79 and under with no reading at target in the last 12 months	Clinic reading of 140/90 or lower, or 135/85 or lower on home monitoring	Annual, treat to target
HYP009	Blood pressure control, aged 80 and over	Patients with hypertension aged 80 and over with no reading at target in the last 12 months	Clinic reading of 150/90 or lower, or 145/85 or lower on home monitoring	Annual, treat to target

Diabetes

Code	What it is	Who is due	What counts as complete	How often
DM012	Foot examination	Patients with diabetes with no foot check in the last 12 months	Foot examination with a risk classification recorded	Annual
DM014	Education referral	Newly diagnosed patients with no referral to structured education	A referral to structured education recorded	Once per diagnosis
DM020	HbA1c control, not frail	Patients with diabetes without moderate or severe frailty whose HbA1c is above 58 mmol/mol	HbA1c of 58 mmol/mol or lower recorded	Annual, treat to target
DM021	HbA1c control, frail	Patients with diabetes with moderate or severe frailty whose HbA1c is above 75 mmol/mol	HbA1c of 75 mmol/mol or lower recorded	Annual, treat to target
DM036	Blood pressure control	Patients with diabetes aged 79 and under without moderate or severe frailty, with no reading of 140/90 or lower in the last 12 months	Clinic reading of 140/90 or lower recorded	Annual, treat to target

Cervical screening

Code	What it is	Who is due	What counts as complete	How often
CS005	Screening, ages 25 to 49	Eligible patients aged 25 to 49 with no screening recorded in the last 3 years	Screening recorded within the last 3 years and 6 months	Every 3 years and 6 months
CS006	Screening, ages 50 to 64	Eligible patients aged 50 to 64 with no screening recorded in the last 5 years	Screening recorded within the last 5 years and 6 months	Every 5 years and 6 months

Smoking

Code	What it is	Who is due	What counts as complete	How often
SMOK002	Smoking status, long-term conditions	Patients with conditions such as asthma, COPD, diabetes or heart disease with no smoking status in the last 12 months	Smoking status recorded	Annual
SMOK004	Cessation offer, all smokers	Patients aged 15 and over who smoke, with no cessation offer in the last 24 months	Cessation advice or referral recorded	Every 24 months
SMOK005	Cessation offer, long-term conditions	Smokers with long-term conditions with no cessation offer in the last 12 months	Cessation support offer recorded	Annual

Smoking indicators are among the quickest to complete. Many need only a status or an offer recorded, which a patient can often give by replying to a message.

How do you use this list?

Start with the treat-to-target indicators, because they take longest. Leave the single-item indicators, like smoking status, for a fast push later in the year. For a full year-end plan, read how to hit your QOF targets before 31 March.

Hippo tracks these indicators for every eligible patient each night and recalls the ones who are due. Get started or book a demo.

You have until 31 March to complete this QOF year. Most practices that miss points do not run out of patients. They run out of appointments in February and March. The fix is to start the hard indicators now and leave the easy ones for last.

When is the QOF deadline?

31 March 2027. Achievement is measured at the end of the QOF year, and annual indicators reset on 1 April. Anything not recorded by 31 March does not count for this year.

Which indicators should you start first?

Treat-to-target indicators. Start them in the autumn.

There are two kinds of QOF work:

• Process indicators complete in one contact. A smoking status recorded. A foot check done. A cessation offer made.
• Treat-to-target indicators need a result inside a threshold. Blood pressure at or below 140/90 for hypertensive patients aged 79 and under (HYP008). HbA1c at or below 58 mmol/mol for non-frail diabetic patients (DM020).

A treat-to-target patient may need a reading, a medication change, and another reading weeks later. If you first contact them in February, there is no time for the second reading. Recall them now.

Process indicators can wait. A patient who only needs a smoking status recorded can be completed in a single text reply in March.

How do you avoid the March pile-up?

Spread recall across the year instead of saving it for the last quarter.

• Run campaigns continuously. A campaign that sends a steady number of invites every day books far more patients than one big push in January.
• Send more than one invite per slot for high-volume clinics. Not everyone books first time. Several invites per available appointment fills clinics faster.
• Avoid recalling patients seen recently. A patient reviewed in February becomes eligible again on 1 April. A delay after recent care stops you spending April appointments on patients who were seen weeks ago.

Which patients are quickest to complete?

The ones who only need something recorded.

Many patients on a register are missing a single item: a smoking status, a blood pressure, a review that happened but was not coded. Find these first with a search, then contact them with a simple message they can reply to. They are cheap points.

What coding loses points?

Missing or wrong codes, not missing care.

• Care done but not coded. A review held without the right code recorded does not count.
• Declines and exceptions. If a patient declines, or an indicator is not appropriate for them, record it with the correct code. Otherwise they stay in your denominator as a miss.
• Same-day requirements. Some indicators need two things recorded together. The annual asthma review (AST007) needs a written personalised action plan on the same day as the review, and an exacerbation count recorded in the month before. Miss either and the review does not count.

Check your coding on a sample of completed patients each month. Errors found in March are expensive. Errors found in October are cheap.

How do you track progress week by week?

Watch achievement by indicator, not just the overall score.

Your overall QOF score hides where the gaps are. Track each indicator weekly against where you need to be by 31 March. If an indicator is behind in December, it will not catch up on its own.

Next steps

Recall is the engine behind most QOF work. Read 7 ways to get more patients booked through recall.

To see how Hippo finds every patient due an indicator and recalls them automatically, get started or book a demo.