Quality and Outcomes Framework - 2012-13

Practice level information is available on the QOF online database (link above).

The national Quality and Outcomes Framework (QOF) was introduced as part of the new General Medical Services (GMS) contract on 1 April 2004. The objective of the QOF is to improve the quality of care patients are given by rewarding practices for the quality of care they provide to their patients. QOF is therefore an incentive payment scheme, not a performance management tool, and a key principle is that QOF indicators should be based on the best available research evidence. Participation by practices in the QOF is voluntary, though participation rates are very high, with most Personal Medical Services (PMS) practices also taking part.

Information in this bulletin was derived from the Quality Management Analysis System (QMAS), a national system developed by NHS Connecting for Health. QMAS uses data from general practices to calculate their QOF achievement.

The QOF contains four main components, known as domains. The four domains are: Clinical Domain, Organisational Domain, Patient Experience Domain and Additional Services Domain. Each domain consists of a set of achievement measures, known as indicators, against which practices score points according to their level of achievement. The 2012/13 QOF measured achievement against 148 indicators; practices scored points on the basis of achievement against each indicator, up to a maximum of 1,000 points. A list of 2012/13 QOF indicators is provided in the Technical Annex.

The QOF has undergone some revisions since it was first introduced, with several changes in 2012/13 from 2011/12. Main changes to the QOF at the start of 2012/13 included the retirement of seven indicators (including five from the Quality and Productivity area), releasing 45 points to fund new and replacement indicators; the introduction of nine new NICE recommended clinical indicators, including two new clinical areas (PAD and Osteoporosis) and additional smoking indicators; the introduction of three new organisational indicators for improving Quality and Productivity which focus on accident and emergency attendances; sixteen other indicators were replaced, either due to changes to indicator wording or coding/business logic changes or to changes to point values or thresholds. Overall, the maximum QOF score remained at 1,000 points.