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 five main components, known as domains. The five domains are: Clinical; Public Health; Public Health - Additional Services; Patient Experience; Quality and Productivity. Each domain consists of a set of achievement measures, known as indicators, against which practices score points according to their level of achievement. The 2013/14 QOF measured achievement against 121 indicators; practices scored points on the basis of achievement against each indicator, up to a maximum of 900 points.
- clinical: the domain consists of 93 indicators across 20 clinical areas (e.g. chronic kidney disease, heart failure, hypertension) worth up to a maximum of 610 points.
- public health: the domain consists of nine indicators (worth up to 113 points) across four clinical areas – blood pressure, cardiovascular disease - primary prevention, obesity and smoking.
- public health – additional services: the domain consists of nine indicators (worth up to 44 points) across four service areas – cervical screening, child health surveillance, contraception and maternity services.
For accessibility purposes, all eight conditions/measures within public health and public health additional services are to be found under the one heading ‘Public Health’.
- quality and productivity: the domain consists of nine indicators (worth up to 100 points) as a service area in its own right (previously part of the now retired organisational domain).
- patient experience: the domain consists of one indicator (worth up to 33 points) that relates to length of consultations.
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 almost 8,000 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 2013/14 from 2012/13. Changes to the QOF at the start of 2013/14 included the retirement of the organisational domain, retirement of 38 indicators, the introduction of a new clinical area (rheumatoid arthritis) and a new public health area (blood pressure), the introduction of 12 new indicators, and coding and wording changes to individual indicators to better reflect the flow of processes. Many of the timeframes have been reduced from 15 months to 12 months, which has had an impact on some registers. Overall, the maximum QOF score was reduced from 1,000 to 900 points. Changes are covered in detail via the following link to NHS Employers:
The sample of the output chart above shows the results for some of the clinical indicator groups for an individual GP practice.
The latest 2013/14 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 five 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 2013-14 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.