The Department of Health has published the latest raw disease prevalence statistics for Northern Ireland, detailing figures for 14 long-term conditions—including asthma, hypertension, dementia and diabetes—across all 305 GP practices. The 2025/26 dataset marks the second year of data collection under the new Clinical Care Domain framework, which replaced the previous Quality and Outcomes Framework (QOF) payment system in a major overhaul of how general practice is funded and monitored.
What the 2025/26 data covers
The publication presents disease register sizes and raw prevalence rates broken down by Local Commissioning Group (LCG), GP Federation and individual practice levels. This allows for detailed geographic analysis of health conditions across Northern Ireland’s 305 active general practices, which currently serve approximately 2.07 million registered patients.
The statistics cover 14 disease registers grouped into four categories:
- Cardiovascular: Atrial fibrillation, coronary heart disease, heart failure, heart failure due to left ventricular systolic dysfunction, hypertension, and stroke
- Respiratory: Asthma and chronic obstructive pulmonary disease (COPD)
- High dependency and other long-term conditions: Cancer, chronic kidney disease (18+), diabetes mellitus (17+), and non-diabetic hyperglycaemia
- Mental health and neurology: Dementia and mental health
Prevalence is measured either as a proportion of total registered patients or as age-specific rates depending on the condition. The data is collected through the General Practice Intelligence Platform (GPIP/QOF) maintained by the Strategic Planning and Performance Group (SPPG).
The Department has made the data available through a comprehensive report and data tables, alongside an interactive dashboard for public access.
From QOF targets to clinical care domains
The 2025/26 publication reflects a fundamental shift in how general practice data is collected and incentivised. The Quality and Outcomes Framework (QOF), which operated since 2004, has been replaced by the Clinical Care Domain within the Northern Ireland Contract Assurance Framework (NICAF) as part of the 2024/25 General Medical Services (GMS) Contract.
This change saw approximately £38.9 million previously allocated to QOF performance targets redirected into core GP funding and indemnity cover. Health Minister Robin Swann welcomed the 2024/25 contract changes, stating:
“This agreement of the GP contract for 2024/25 is very welcome news. Whilst the budget provided to me by the Executive does not allow me to make a substantial increase in the overall value of the contract, I am pleased that the agreement announced today makes significant progress against key aims identified by GPs in their negotiations, including provision of dedicated funding for their indemnity costs.”
Dr Alan Stout, chair of the BMA’s Northern Ireland General Practitioners Committee (NIGPC), explained the rationale behind the move away from target-based payments:
“When we entered negotiations we were clear that we had three aims; to simplify the contract, to ensure a fair uplift and to make significant progress on indemnity. We have managed to negotiate successfully in these key areas for this year, and we secured a commitment from the Department and SPPG to further review the contract for subsequent years.”
Under the new system, practices maintain disease registers to demonstrate appropriate clinical care, but without the previous points-based payment mechanism. The Department notes that “practices are required to continue to code appropriately to record that good clinical care is being maintained.”
Pressures on the data collection system
The publication comes amid significant strain across general practice. The number of active GP practices has fallen from 318 in March 2023 to 305 by March 2025—a reduction of 13 practices in just two years. Over the longer term, practice numbers have dropped 13% since 2014, while the average patient list size has increased by over 23% to 6,777 patients per practice.
GP partners remain in dispute with the Department over the 2025/26 contract, with the BMA having balloted members for collective action. The association has advised practices to continue collective action measures, noting that “many of the measures you have been undertaking as part of collective action were UNFUNDED, therefore you should not resume those tasks.”
Despite these pressures, the Department reports that all 305 practices voluntarily provided data for the 2025/26 prevalence statistics. However, the raw prevalence rates take no account of population differences in age or gender profiles, meaning direct comparisons between practices with different demographics require careful interpretation.
Gaps and unanswered questions
While the publication provides comprehensive geographic breakdowns, it offers limited analysis of the underlying causes of regional variation or trends over time. The Department notes that year-on-year changes in register sizes may reflect demographic shifts, improvements in case finding, or changes to register definitions—making trend interpretation complex.
Significantly, the statistical release does not address how the removal of QOF financial incentives has affected data completeness or quality, nor does it link prevalence data to health outcomes or access metrics. With general practice handling increasingly complex care amid workforce shortages, the sustainability of maintaining detailed disease registers without dedicated funding remains unclear.
Key questions arising from the publication include:
- How will the Department assure data quality and completeness now that QOF financial incentives have been removed, and will the “light touch” assurance framework be sufficient to maintain standards?
- With practice closures concentrating patient lists and increasing workload, how sustainable is the administrative burden of maintaining 14 separate disease registers across all 305 practices?
- Given significant regional variation in disease prevalence, what specific interventions are planned to address health inequalities in areas with the highest chronic disease burdens?
- How will the 2026/27 contract negotiations address the ongoing dispute, and will future prevalence data collection be affected if collective action escalates?
- Can the Department provide analysis linking these prevalence figures to health outcomes, given that high disease registration does not necessarily equate to effective management or improved patient health?
The 2025/26 raw disease prevalence data is available now through the Department of Health website, with the next annual release expected in May 2027.