Achievement
Reference to ‘QOF achievement’ often refers to the percentage of available QOF points achieved. If a GP practice achieves the full QOF points, it has achieved 100% of the points available and may be said to have 100% achievement across the whole QOF.

The level of achievement for certain elements of QOF can be expressed in the same way. A GP practice achieving all QOF points available for indicators in the clinical domain can be said to have 100% clinical achievement even though it may not have 100% achievement overall.

GP practices achieve the maximum QOF points for most indicators (especially clinical indicators) when they have delivered the maximum threshold to achieve the points available. For many indicators, a GP practice must provide a certain level of clinical care to 90% of patients on a specific clinical register to achieve the maximum points./p>

Personalised care adjustments (PCAs)
PCA reporting rates reflect the percentage of patients who are not included when determining QOF achievement and are presented for applicable indicators in QOF. PCAs can be applied to patients for several specified reasons and are usually the result of a patient or a GP decision at a personal level.

Examples of PCAs could be patient or carer refusal of treatment, a patient cancels or does not attend a consultation appointment, or a GP’s advice that two types of medication or treatment methodology should not be administered simultaneously.

PCAs are only measured at indicator level, not condition level, as a patient could be omitted from more than one indicator within a condition but would be counted more than once if these omissions were summed.

Prevalence
QOF registers are constructed to underpin indicators on quality of care, and they do not necessarily equate to prevalence as defined by epidemiologists.

The number of patients on indicator registers in the clinical domain can be used to calculate recorded disease prevalence, expressing the number of patients on each register as a percentage of the number of patients on GP practices’ lists, as described below:

Disease prevalence = (Number of patients on clinical register / Number of patients on GP practice list) ∗ 100

Where age-specific registers are used, disease prevalence can be calculated as:

Disease prevalence = (Number of patients on clinical register / Number of patients in relevant age band on GP practice list) ∗ 100

Technical annex
The technical annex on the QOF publication page provides further information on QOF and the data published for 2023-24: digital.nhs.uk/.../quality-and-outcomes-framework-achievement-prevalence-and-exceptions-data/2023-24/technical-annex