The Quality and Outcomes Framework (QOF) is a voluntary annual reward and incentive programme for all GP practices in England, detailing practice achievement results. It is not about performance management but resourcing and rewarding good practice.

The QOF contains five main components, known as domains. The five domains are: Clinical; Public Health and Public Health – Additional Services, Public Health – Vaccination and Immunisation and Quality Improvement. Each domain consists of a set of achievement measures, known as indicators, against which practices score points according to their level of achievement. The 2021-22 QOF measured achievement against 72 indicators; practices scored points based on achievement against each indicator, up to a maximum of 635 points.

• Clinical: consists of 57 indicators across 20 clinical areas (e.g. chronic kidney disease, heart failure, hypertension) worth up to a maximum of 401 points.
• Public health: consists of five indicators (worth up to 85 points) across three clinical areas – blood pressure, obesity 18+ and smoking 15+.
• Public health – additional services: consists of two indicators (worth up to 11 points) across one service area – cervical screening.
• Public health – vaccination and immunisation: consists of four indicators (worth up to 64 points) across one service area - vaccination and immunisation
• Quality improvement: consists of four indicators (worth up to 74 points) across two areas – early cancer diagnosis and care of people with learning disabilities.
  For accessibility purposes, all conditions/measures within public health, public health additional services and public health vaccination and immunisation are to be found under the one heading ‘Public Health’.

The QOF gives an indication of the overall achievement of a practice through a points system. Practices aim to deliver high quality care across a range of areas for which they score points. 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 this online database to allow patients and the public easy access to the latest annual QOF data. NHS Digital 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 to other GP practices in the local area and the national results across England, but caution should be taken in interpreting the results, as explained 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 are collected from 6,470 (97.5%) GP practices with approximately 61 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.

To support the ongoing response to COVID-19, practices were advised that payment protection would be applied to a number of QOF indicators in December 2021. NHS England and Improvement published information about the implementation of QOF payment protection in the 2021-22 reporting year, which can be found in a letter to practice . Payment protection was also implemented in the 2020-21 reporting year, this was detailed in the NHS England and Improvement Guidance for General Medical Services Contract document.

Additionally, Tthe following changes to QOF indicators have been implemented in 2021-22:

• A new vaccination and immunisation domain consisting of four. Three of these indicators focus on routine childhood vaccinations and one on incentivising the delivery of shingles vaccinations.
• The reintroduction of three indicators focused on patients with a serious mental illness to promote improved uptake in all six elements of the SMI physical health check.
• A new indicator focused on cancer care has been introduced and amendments made to the timeframe and requirements for the cancer care review indicator.
• The four flu indicators have been retired.
• The date of diagnosis has been amended to ‘on or after April 2021’ for the asthma, heart failure and COPD diagnostic indicators.
• To account for the impact of the COVID-19 pandemic on care, the Learning Disabilities and Supporting Early Cancer Diagnosis Quality Improvement modules are to be repeated in their intended format (prior to amendments for the refocusing of QOF in September 2020) with some slight modifications to account for the impact of the pandemic on care.
• The total points available to practices is 635 and all payments will be subject to prevalence and list size adjustments.

The implementation of payment protection and the changes to QOF indicators should be considered when comparing 2021-22 QOF data with QOF data for previous years.

Additional information can be found in the NHS England » Update on Quality Outcomes Framework changes for 2021/22 published by NHS England and NHS Improvement.

The sample of the output chart below shows the prevalence for some of the conditions for an individual GP practice.

The sample of the output chart below shows the results for some of the clinical indicator groups for an individual GP practice.

The results for previous years are presented in the chart, which also displays the year's Sub Integrated Care Board Location (Sub ICB Location) and England averages.

Similar charts are available for the total achievement results, the 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 for years prior to 2021-22 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 practice achievement with other practices and the local Sub ICB Location and England averages
• find explanations of the QOF clinical indicators
• export simple data tables of multiple practice results

For the 2020-21 reporting year, this functionality is restricted to disease prevalence only.

• The QOF information is collected at an aggregate level for each practice and does not refer to specific patients, therefore it cannot show how well a practice treats its patients.
• The QOF only reflects part of the work that a practice is responsible for; it measures only those conditions specified by NICE and used in the 2021-22 GMS contract. As such NHS Digital does not recommend or endorse the use of QOF data to rank practices into league tables. Users 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 relevant for specialist centres and those with specific demographics, e.g. a university practice whose patients are primarily students.
• Participation in the QOF is voluntary – no data are available for those practices that do not choose to participate in the QOF.

The QOF FAQs are available on the QOF publication page:
digital.nhs.uk/data-and-information/publications/statistical/quality-and-outcomes-framework-achievement-prevalence-and-exceptions-data/2021-22/frequently-asked-questions