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Quality and outcomes framework guidance

April 2008

This is the second revision of the Quality and Outcomes Framework (QOF) which was introduced as part of the new General Medical Services (GMS) contract in 2004. Initial revisions were made in 2006 which saw the addition of new clinical areas and a reduction in indicators in the organisational domain. This second revision again sees a reduction of indicators in the organisational domain and new indicators in the patient experience domain. The 2008 revisions also include changes to some of the clinical areas as a result of the recent review of the evidence for QOF by the expert panel. In particular there have been changes to either the indicators and/or guidance in: stroke, diabetes, COPD, palliative care, mental health, asthma, depression, CKD, atrial fibrillation and smoking.

Section 1: Principles
The following principles relating to the Quality and Outcomes Framework (QOF) were agreed by the negotiators.

1. Indicators should, where possible, be based on the best available evidence.
2. The number of indicators in each clinical condition should be kept to the minimum number compatible with an accurate assessment of patient care.
3. Data should never be collected purely for audit purposes.
4. Only data which are useful in patient care should be collected. The basis of the consultation should not be distorted by an over-emphasis on data collection. An appropriate balance has to be struck between excess data collection and inadequate sampling.
5. Data should never be collected twice ie data required for audit purposes should be data routinely collected for patient care and obtained from existing practice clinical systems.