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 four main components, known as domains. The four domains are: Clinical; Public Health and Public Health – Additional Services 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 2020-21 QOF measured achievement against 68 indicators; practices scored points based on achievement against each indicator, up to a maximum of 567 points.

• Clinical: consists of 57 indicators across 20 clinical areas (e.g. chronic kidney disease, heart failure, hypertension) worth up to a maximum of 386 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 22 points) across one service area – cervical screening.
• 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 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 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 6,571 GP practices with approximately 60 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.

This website includes prevalence data only for QOF 2020-21, as the changes outlined below mean that the achievement and personalised care adjustment (PCA) data extracted for the 2020-21 reporting year could be misleading and not representative of activity undertaken, and any comparisons with data from previous years are not recommended. The 2020-21 achievement and PCA data are not published on this website; they are available in the .csv files included in the 2020-21 QOF publication.

To support the ongoing response to COVID-19 and the need to proactively target and support the most vulnerable patients during this period the following changes have been implemented in 2020-21:

• Some indicators will continue to be paid based on practice performance. These are:
  • The four flu indicators targeted on patients with coronary heart disease, COPD, stroke/TIA and diabetes, had the number of points attached to them doubled.
  • The two cervical screening indicators had the number of points attached to them doubled.
  • Register indicators.
• The requirements of the Quality Improvement (QI) domain have been amended to focus upon care delivery and restoration of services using QI tools;
• The remaining 354 points were subject to income protection based upon historical practice performance and to practices agreeing an approach to QOF population stratification with their commissioner.
• The total points available to practices is 567 and all payments will be subject to prevalence and list size adjustments.

Additional information can be found in the Guidance for GMS contract 2020/21 in England published by NHS England and NHS Improvement and GOV.UK - general medical services statement of financial entitlements (amendment) directions 2021.

The sample of the output chart below shows the prevalence for some of the conditions for an individual GP practice. The latest 2020-21 results include prevalence only.

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 Clinical Commissioning Group (CCG) 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 2020-21 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 CCG 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 2020-21 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/2020-21/frequently-asked-questions