Quality & Outcomes Framework

The Quality and Outcomes Framework (QOF) is a system for the performance management and payment of general practitioners in the National Health Service.

The QOF rewards GPs for implementing good practice in their surgeries. The QOF comprises a range of criteria which are grouped into 4 domains: Clinical, Organisational, Patient Experience and Additional Services.

The criteria are designed around best practice and have a number of points allocated for achievement. At the end of the financial year the total number of points achieved by a surgery is collated and converted into a payment amount for the surgery which takes account of the size of the practice and the number of patients diagnosed with chronic illness.

• Clinical Domain focuses on the secondary prevention of coronary heart disease and points are awarded for diagnosis and initial management, as well as ongoing management of the condition. This takes into account areas including blood pressure, cholesterol and influenza immunisation, alongside several other treatments.
• Patient Experience Domain focuses on monitoring patient health whilst ensuring a patient's practice experience falls within national guidelines. This is outlined through a series of sub-sections identifying patient satisfaction alongside measurements of response of conditions including Heart Failure, Stroke & TIA, Hypertension, Diabetes Mellitus, COPD, Epilepsy, Hypothyroid, Cancer, Pallative Care, Mental Health, Asthma, Dementia, Depression, CKD, Atrial Fibrillation, Obesity, Learning Difficulties and Smoking Addiction.
• Organisational Domain focuses on practice management and the provision of information to patients. The Domain is separated into five sub-sections targeting Records and Information, Information for Patients, Education and Training, Practice Management and Medicines Management.
• Additional Services Domain focuses on four key services provided to patients by the GP and/or practice staff. Points are awarded for the delivery of these services, support provided to patients and the management of practice protocol in line with the Department of Health's national guidelines. The four key services are Cervical Screening, Child Health Surveillance, Maternity Services and Contraceptive Services.