The Quality and Outcomes Framework 2008/09

Already familiar with The QOF? Go straight to what you need via the links on the right. New to The QOF? Get started by reading our what, why, how and where sections.

What is The QOF?

The Quality and Outcomes Framework (QOF), is a voluntary annual reward and incentive programme for all GP surgeries in England which is part of GP contracts. Results of GP practices' achievement against the QOF are published each year.

The QOF is not about performance management, but resourcing and then rewarding good practice. For 2008-2009, a total of 8,229 GP practices in England are included in the published results, covering almost 100 per cent of registered patients in England.

The QOF has four main components, known as domains. Each domain consists of a set of measures of achievement, known as indicators, against which practices score points according to their level of achievement.

  1. Clinical: 80 indicators across 19 clinical areas (e.g. coronary heart disease, heart failure, hypertension)
  2. Organisational: 43 indicators across five organisational areas - records and information; information for patients; education and training; practice management and medicines management
  3. Patient care experience: four indicators that relate to length of consultations and to patient surveys
  4. Additional services: eight indicators across four service areas which include cervical screening, child health surveillance, maternity services and contraceptive services.

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Why do we have The QOF?

The QOF was introduced as part of the new General Medical Services (GMS) contract on 1 April 2004. Participation rates are very high, with most Personal Medical Services (PMS) practices also taking part. Practices score points on the basis of achievement against each indicator, up to a maximum of 1,000 points.

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How is it measured?

Achievement against the QOF is measured by the Quality Management Analysis System (QMAS), a national IT system developed by NHS Connecting for Health (CfH). QMAS ensures consistency in the calculation of quality achievement and disease prevalence, and is linked to payment systems.

It is not a comprehensive source of data on quality of care in general practice, but it is potentially a rich and valuable source of such information, providing the limitations of the data are acknowledged.

The Prescribing Support Unit (PSU), part of The NHS Information Centre, works on behalf of the Department of Health and in collaboration with CfH to obtain extracts from QMAS to support the publication of the QOF information.

Further details on how the QOF is measured (e.g. QMAS system; practice list size, patient exceptions etc) can be found in the QOF 2008/09 bulletin.

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Where do I view the QOF results?

1. Online database

Find the results for your local surgery.

2. Bulletin

Read the key findings and explanations.

3. Data tables

View national, SHA, PCT and practice level data tables.

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