Quality and outcomes framework (QOF)

QOF is a voluntary annual reward and incentive programme for GP practices in England, Wales and Northern Ireland. Find the latest frameworks for 2019/20.
Location: England Wales Northern Ireland
Audience: GPs Practice managers
Updated: Friday 1 May 2020
GP practice article illustration

Find the latest changes to the quality and outcomes framework (QOF) or equivalent by nation.

QOF has not been in operation in Scotland since 2016.


Changes to the framework in England 2019/20

The value of a QOF point is £187.74.

Retired indicators

175 points from 28 'low-value' indicators. These include cholesterol check for diabetes, annual FEV1 and osteoporosis indicators.

New indicators

101 retired points were recycled into 15 more appropriate indicators. New indicators cover five areas, including:

  • aligning blood pressure control targets with NICE guidance
  • reducing iatrogenic harm
  • improving outcomes in diabetes care
  • an age-appropriate cervical screening offer
  • pulmonary rehab for patients with COPD
  • weight management for patients with schizophrenia, bipolar disorder and other psychoses.

Quality improvement 

The remaining 74 points were used to create two quality improvement modules. 

  • Prescribing safety: this module will cover the safe prescribing of NSAIDs, lithium and valproate in women of child bearing age and will dovetail with the expansion of clinical pharmacists in general practice.
  • End-of-life care: the current QOF indicator on end-of-life care has been retired, and instead this module will focus on the wider aspects of care for patients who are expected to die soon.

Personalised care adjustments

Exception reporting was replaced with a more precise ‘personalised care adjustment’. It allows practices to differentiate between five different reasons for adjusting care and removing a patient from the indicator.

Ongoing amendments

NHS England and the BMA GP committee agreed to an ongoing programme of indicator review in key priority areas, including heart failure, asthma and COPD care for changes in 2020/21, and mental health for changes in 2021/22.


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