The Quality and Outcomes Framework (QOF) is a system for the performance management and payment of general practitioners (GPs) in the National Health Service (NHS) in England, Wales, Scotland and Northern Ireland.
It was introduced as part of a new general medical services (GMS) contract in April 2004, replacing various other fee arrangements.
It was intended to improve the quality of general practice and was part of an effort to solve a shortage of GPs.
[1] The clinical areas now include coronary heart disease, heart failure, stroke and transient ischaemic attacks, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, epilepsy, hypothyroidism, cancer, palliative care, mental health and asthma.
Added in 2006 were dementia, depression, chronic kidney disease, atrial fibrillation, obesity, learning disabilities and smoking.
In order for the GPs not to lose points on account of circumstances that are outside their control they can exclude those patients from counting towards their achievement by "exception reporting" them.
Tim Burr, head of the National Audit Office, said in 2008: "There is no doubt that a new contract was needed and there are now 4,000 more GPs than five years ago.
[7][8][9] Ben Bradshaw, the Health Minister said: "The GP contract… has stemmed the haemorrhaging of GPs from the NHS and improved the quality of care for the public.
Laurence Buckman, chairman of the BMA's GP committee, said "The early evidence is that the contract is leading to improvements in clinical care".
Clinical commissioning groups in Thanet and in York also asked permission to develop a local alternative but were refused.
[13] In January 2017, the clinical commissioning groups in Leeds agreed to suspend 80% of the QOF targets for the rest of 2016/17.