COVID-19: toolkit for GPs and GP practices

QOF (quality and outcomes framework)

Location: England Wales Scotland
Audience: GPs Practice managers
Updated: Tuesday 14 June 2022
Topics: COVID 19, GP practices
2021/22 QOF updates

See more on 2021/22 updates and the suspension of QOF in December in our regular QOF briefing.

QOF 2020/2021

Due to the pandemic, QOF payments for 2020/21 were calculated differently to normal. Some indicators were based on achievement, some were awarded in full and some were income protected.

Income protection was based on achievement in previous years but uprated for the 2020/21 QOF point value, prevalence and list size adjustment.

Therefore, practices did not have floor for payments equal to payments in previous years – it was a different calculation.

Type of indicator or achievement Number of points
Based on achievement for 2020/21 139
Awarded in full 74
Based on previous achievement 354
Total 567

Practice achievement

Total points: 139

Achievement Total points
Disease registers 81
Cervical screening 22 (doubled from 11)*
Flu vaccination 36 (doubled from 18)*

*in order to double those indicators – 11 points were taken from the asthma domain, and 18 points were taken from the NDH001 indicator (meaning this new indicator for 2020 was not introduced as planned).

These indicators were awarded in the normal way, based on practice achievement, using the QOF point value for 2020/21 (£194.83).

So, if a practice achieved the same as previous years for these indicators, their payment would be higher because of the increase in the number of points and the increase in QOF point value.


Awarded in full

Total points: 74

Quality improvement indicators awarded in full to all practices, using the QOF point value for 2020/21.


Income protected

Total points: 354

All other indicators are subject to income protection.

Most of these indicators are protected based on 2018/19 achievement levels (at 2020/21 QOF point value, prevalence and list size).

However, some of these indicators (total points: 80) were new for 2019/20, and therefore protection can only be based on 2019/20 achievement (but again at 2020/21 QOF point value, prevalence and list size).

How income protected indicators will operate

The total number of points for each domain indicator as of 2020/21 (not including those above that require achievement) is multiplied by the percentage of points achieved in 2018/19 at a domain level (again, not including the achievement indicators), then rounded to the nearest whole number.

This will calculate the achievement for 2020/21, to which the QOF point value, prevalence and list size adjustment for 2020/21 will then apply.

For example, for the asthma domain there are 34 income protected points available for 2020/21. If a practice achieved 70% across the domain in 2018/19, then they would get 23.8 points for 2020/21, rounded to 24. This is then multiplied by £194.83 and adjusted for list size and prevalence.

If there is no or incomplete achievement data for 2018/19, achievement data for 2019/20 will be used.

If there is no or incomplete achievement data for both years, the commissioner will review and decide a fair level of achievement based on, for example, historic achievement and the impact of the pandemic.

We understand there to be very few practices that have no or incomplete data for both years. We would encourage such practices to contact their CCG to ensure their achievement has been calculated fairly.

Any practice mergers will use the achievement data of the ODS coded practice active in 2020/21.