The Quality and Outcomes Framework (QOF) is a voluntary annual reward and incentive programme for all GP surgeries in England, detailing practice achievement results. It is not about performance management but resourcing and then rewarding good practice.
The QOF contains three main components, known as domains. The three domains are: Clinical; Public Health and Public Health – Additional Services. Each domain consists of a set of achievement measures, known as indicators, against which practices score points according to their level of achievement. The 2014/15 QOF measured achievement against 81 indicators; practices scored points on the basis of achievement against each indicator, up to a maximum of 559 points.
- clinical: the domain consists of 69 indicators across 19 clinical areas (e.g. chronic kidney disease, heart failure, hypertension) worth up to a maximum of 435 points.
- public health: the domain consists of seven indicators (worth up to 97 points) across four clinical areas – blood pressure, cardiovascular disease – primary prevention, obesity 16+ and smoking 15+.
- public health – additional services: the domain consists of five indicators (worth up to 27 points) across two service areas – cervical screening and contraception.
For accessibility purposes, all six conditions/measures within public health and public health additional services are to be found under the one heading ‘Public Health’.
The QOF gives an indication of the overall achievement of a surgery through a points system. Practices aim to deliver high quality care across a range of areas for which they score points. Put simply, the higher the score, the higher the financial reward for the practice. The final payment is adjusted to take account of surgery workload, local demographics and the prevalence of chronic conditions in the practice's local area.
To report the latest annual QOF points, The Health and Social Care Information Centre (HSCIC) has developed this online database to allow patients and the public easy access to this useful data that indicates how well their surgery is doing. The HSCIC is working to make information more relevant and accessible to patients and the public, regulators, health and social care professionals and policy makers, leading to improvements in knowledge and efficiency.
Browse the online database to find the results for your local surgery.
Other searches will compare your local GP practice against other GP practices in the local area and the national results across England, but caution should be taken in interpreting the results, as detailed below in “what this site cannot tell you”.
The online database provides easy access to comprehensive information on the pattern of common chronic diseases such as asthma, diabetes and coronary heart disease. In terms of scale, the data for QOF is collected from nearly 7,800 GP practices with over 56 million registered patients in England.
The QOF helps practices compare the delivery and quality of care currently provided against the achievements of previous years. Ultimately, the aim is to improve standards of care by assessing and benchmarking the quality of care patients receive. The QOF has undergone some revisions since it was first introduced, with several changes in 2014/15 from 2013/14.
QOF 2014/15 changes
- A reduction in the maximum number of points available to 559.
- Retirement of two domains; the quality and productivity domain and the patient experience domain.
- Three groups of indicators; hypothyroidism, child health surveillance and maternity have been retired. There are 26 other individual indicators that have been retired, from within conditions that are still measured in the QOF.
- No new indicators or indicator groups have been added this year.
- Some minor changes to indicators have resulted in new indicator numbering. Epilepsy now has only one indicator, the presence of a register. Learning disability has had the age restriction removed, and is no longer for those aged 18 or over. Blood Pressure has also changed its age restriction from age 40 or over to age 45 or over.
Changes to the QOF business rules and indicators for 2014/15 are available for download from NHS Employers:
Download: Summary of changes to QOF indicators 2014-15 1.6Mb pdf.
The sample of the output chart above shows the results for some of the clinical indicator groups for an individual GP practice.
The latest 2014/15 results are presented in the chart, which also displays the current year's CCG (Clinical Commissioning Group) and England averages.
Similar charts are available for the total achievement results, the three individual domain results and the underlying achievement details for the individual indicators within each indicator group.
You can use this specially designed website to make specific searches on achievement in the following ways:
- search for any GP practice in England
- find the overall achievement score for any practice
- breakdown the achievement by a series of clinical measures
- compare local surgery achievement with other surgeries and the local CCG and England averages
- find explanations of the QOF clinical indicators
- export simple data tables of multiple practice results
- The QOF information is collected at an aggregate level for each general practice and does not refer to specific patients, hence QOF cannot show how well a surgery treats its patients.
- The QOF only reflects part of the work that a general practice is responsible for; it measures only those conditions specified by NICE in the 2014-15 GMS contract. As such The HSCIC does not recommend or endorse the use of QOF data to rank practices into league tables. The reader should also bear in mind that a practice which has no patients who have a particular QOF-measured condition, cannot score any QOF points for that clinical area, and could wrongly be perceived as being a lower performer in any rank of points scored. This is particularly pertinent for specialist centres and those with specific demographics, e.g. a university practice whose patients are primarily students.