The Quality and Outcomes Framework (QOF) is a component of the General Medical Services contract.

QOF is a voluntary annual reward and incentive programme for all GP surgeries in England, detailing practice achievement results. It is not intended as a performance management tool but to resource and reward good practice.

This topic covers the role of the National Institute for Health and Care Excellence (NICE) in the QOF, and QOF content and structure.

As of April 2013, the QOF has varied across England and the devolved administrations. NHS England is responsible for the commissioning of primary care in England.

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 QOF in line with the recommendations of the QOF Review which was published in July 2018. The QOF contains four domains: Clinical; Public Health and 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.

GPC England has negotiated minimal updates to the GP contract for 2021/22 to give practices support and stability through the Covid-19 pandemic period.

Four new indicators covering immunisations and vaccinations will be added to the QOF in 2021/22 transferring almost £60m from the Direct Enhanced Service (DES) to QOF with a new domain to be introduced and the Childhood Immunisation DES replaced with item of service (IOS) payments.

It should be noted, whilst we are in the coronavirus (Covid-19) pandemic period, elements of the GP contract and reporting have been amended. Other practice administration burdens have also been reduced to help support general practice and routine CQC inspections were suspended.

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