The Quality and Outcomes Framework (QOF) is a component of the General Medical Services (GMS) contract, introduced in 2004. It is a voluntary annual reward and incentive programme for all general practices in England, designed to remunerate practices for good quality care provision for their patients and provide funding to further improve quality of healthcare delivered. The QOF contains the following domains: Clinical, Public Health, Public Health — Additional Services and Quality Improvement. Each domain comprises of a set of achievement measures, known as indicators, against which practices attain points depending on level of achievement attained.

Since 2013, the QOF has varied across England and the devolved administrations. In January 2019, NHS England agreed a new five-year framework for GP contract reform to implement The NHS Long Term Plan; this included several improvements to the QOF in line with the recommendations of the QOF Review which was published in July 2018.

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