About the Quality and Outcomes Framework (QOF)
What is the QOF?
Introduced in 2004 as part of the General Medical Services Contract, the QOF is a voluntary incentive scheme for GP practices in the UK, rewarding them for how well they care for patients.
The QOF contains groups of indicators, against which practices score points according to their level of achievement. NICE's role focuses on the clinical and public health domains in the QOF, which include a number of areas such as coronary heart disease and hypertension.
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. Put simply, the higher the score, the higher the financial reward for the practice. The final payment is adjusted to take account of the practice list size and prevalence. The results are published annually.
Consultation on indicators process guide: August - November 2013
We are currently consulting on the proposed indicators process guide.
The NICE QOF Indicator Programme
NICE's role is to manage the process to develop the clinical and public health indicators for the QOF. This involves prioritising areas for new indicator development, developing and selecting indicators, advising on thresholds and ensuring consultation with individuals and stakeholder groups.
We also recommend whether existing indicators should continue to be part of the QOF. For example, where the activity being measured has become part of standard clinical practice, there is no longer a need to provide a financial incentive.
For details of the indicators in the NICE QOF Indicator menu please view the NICE Menu of Indicators.
This also contains full details of the decision process for the recommendation of potential indicators.
For details of the recommendations relating to existing indicators please view the Advisory Committee outputs.
NHS Employers (on behalf of the four UK health departments) and the BMA negotiate which indicators should be applied nationally as part of the QOF and what the value of the indicators should be.
Our process guide sets out in detail the processes involved in managing the development of indicators for the QOF, which ensure that indicators are developed in an open, transparent and timely way, with input from individuals and stakeholder organisations.
For details of all current QOF indicators and guidance please view the NHS Employers website.
For details of practice results against QOF indicators please view the Health and Social Care Information Centre´s website.
Why is NICE involved?
A public consultation document was published by the Department of Health (DH) in late October 2008 to involve patients, carers, NHS professionals and commissioners in how a more independent and transparent process for reviewing and developing indicators should work. The consultation set out proposals on how this process should work in England, and the DH held discussions with the devolved administrations about how to ensure a collaborative approach across the UK. All four UK countries have agreed to take part in the NICE-led process.
What NICE adds
One of NICE's acknowledged key strengths is our robust process for assessing what is both clinically and cost effective for use in the NHS.
It is important that the process for assessing evidence to review or develop QOF indicators is separate from the process for negotiating and approving changes to the QOF. NICE acts independently when assessing evidence and developing indicators for the QOF.
By overseeing the process of developing and reviewing performance indicators for the QOF, we ensure that the principles behind our recommendations are reflected in the indicators. This can encourage the implementation of guidance and lead to improvements in care across the UK.
A number of partner organisations contribute to the development of clinical and public health indicators for the QOF. A brief summary of the role played by these organisations is given below.
The Primary Care Group in the School of Health and Population Sciences at the University of Birmingham and the York Health Economics Consortium (YHEC)
The Primary Care Group in the School of Health and Population Sciences at the University of Birmingham in collaboration with the York Health Economics Consortium (YHEC) supports NICE to develop indicators on clinical or public health topics topics by piloting indicators and undertaking cost effectiveness analysis.
The HSCIC is responsible for managing the production of business rules and data extraction solutions to support the process, including Read code releases, and works with the four UK health departments.
NICE works closely with many professional, NHS and public sector organisations, including those representing patients and carers. The following list is not exhaustive, but identifies other key partners in the QOF Indicator Programme:
- British Medical Association
- Department of Health
- General Practitioners Committee
- Health and Social Care Information Centre
- NHS Employers
- NHS England
- NHS Quality Improvement Scotland and the Scottish Intercollegiate Guidelines Network (SIGN)
- Northern Ireland Department of Health, Social Services and Public Safety
- Public Health England
- Royal College of General Practitioners (RCGP)
- Scottish Government Health Directorates
- Welsh Assembly Government
This page was last updated: 27 August 2013