How we perform (QOF)

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 2018/19 QOF measured achievement against 77 indicators; practices scored points based on achievement against each indicator, up to a maximum of 559 points.

  • Clinical: consists of 65 indicators across 19 clinical areas (e.g. chronic kidney disease, heart failure, hypertension) worth up to a maximum of 435 points.
  • Public health: consists of seven indicators (worth up to 97 points) across four clinical areas – blood pressure, cardiovascular disease – primary prevention, obesity 18+ and smoking 15+.
  • Public health – additional services: 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.

NHS Digital has developed an online database to allow patients and the public easy access to the latest annual QOF points as an indication of how well the surgery is doing. NHS Digital is working to make information more relevant and accessible to patients and the public, regulators, health and social care professionals and policymakers, leading to improvements in knowledge and efficiency.

For more information about QOF follow this link here:

To see our latest CQC report please click here