2004-05 and 2005-06
The QOF was introduced in 2004-05, the same indicator set was used in 2005-06. In 2004-05 and 2005-06 practices were able to achieve a maximum QOF score of 1,050 points.
From April 2006 a revised QOF was introduced, including new clinical areas and revising some clinical indicators. The revised QOF continued to measure achievement against a set of evidence-based indicators but allowed a possible maximum score of 1,000 points.
Some changes were made at the start of 2008-09, with the most significant change being the introduction of two new indicators within the Patient Experience domain. The new indicators, PE7 and PE8, were derived from the results of the national GP Patient Survey, and rewarded practices for providing 48-hour appointments (PE7) and advanced booking (PE8). These two new indicators were worth a total of 58.5 QOF points, and their introduction coincided with the removal of some indicators (or points associated with indicators), so that the maximum QOF score remained at 1,000 points.
Further changes to the QOF were made at the start of 2009-10 and remained in force for 2010-11. These included:
The introduction of new indicators in the existing heart failure, chronic kidney disease, depression and diabetes clinical indicator sets;
The introduction of two new indicators under a new cardiovascular disease (primary prevention) clinical indicator set;
The removal of some patient experience indicators; changes to contraception indicators within the Additional Services domain of the QOF; and
Various changes to the points values of some QOF indicators.
Overall, the maximum QOF score remained at 1,000 points.
Changes to the QOF at the start of 2011-12 included:
The introduction of new indicators in the epilepsy, learning disability and dementia clinical indicator sets and the introduction of a new set of indicators measuring quality and productivity.
There were 12 indicators across a range of sets retired, 22 indicators were replaced, either due to changes to indicator wording or coding/business logic changes, five indicators had changes to point values or thresholds.
Overall, the maximum QOF score remained at 1,000 points
Changes to the QOF at the start of 2012-13 included the retirement of seven indicators (including five from the Quality and Productivity area), releasing 45 points to fund new and replacement indicators. There were nine new NICE recommended clinical indicators introduced, including two new clinical areas (PAD and Osteoporosis) and additional smoking
indicators. There were three new organisational indicators for improving Quality and Productivity which focussed on accident and emergency attendances.
Sixteen other indicators were replaced, either due to changes to indicator wording or coding/business logic changes or to changes to point values or thresholds.
Overall, the maximum QOF score remained at 1,000 points.
- Changes to the QOF at the start of 2013-14 included a reduction in the maximum number of points available to 900.
- The indicator codes have all been reset and re-ordered, starting with 001 for each set of indicators to reflect the flow of processes.
- The organisational domain was retired, adding to a retirement of a total of 38 indicators
- A new public health domain was introduced (including a subset of additional services indicators), with some existing indicators reallocated to this new domain.
- There was an introduction of a new public health measure: blood pressure, introduction of a new clinical condition: rheumatoid arthritis, and in total, 12 new indicators were introduced
- Thirteen indicators have been replaced along with changes to the wording where necessary; this was predominantly wording changing from 'practice' to 'contractor'.
- There was of the end-of-year overlap for most indicators by changing the indicator timeframe from 15 to 12 months or 27 to 24 months.
- Changes to the QOF at the start of 2014-15 include a reduction in the maximum number of points available to 559.
- There has been retirement of two domains; the quality and productivity domain and the patient experience domain.
- Three groups of indicators; hypothyroidism, child health surveillance and maternity have been retired. There are 26 other individual indicators that have been retired, from within conditions that are still measured in the QOF.
- No new indicators or indicator groups have been added this year.
- Some minor changes to indicators have resulted in new indicator numbering. Epilepsy now has only one indicator, the presence of a register. Learning disability has had the age restriction removed and is no longer for those aged 18 or over. Blood Pressure has also changed its age restriction from age 40 or over to age 45 or over.
- There has been no change to the maximum number of points available (559). However, the total number of indicators has fallen from 81 to 77; some indicators have been retired or replaced, and the number of points assigned to some indicators has been changed. The number of points available in each domain has remained the same.
- No indicator groups have been added or removed
- Some minor changes to indicators’ wording, timeframe or maximum available points have resulted in new indicator numbering. This affects the dementia, chronic kidney disease and obesity indicator groups as follows:
- DEM002 and DEM003 are now numbered DEM004 and DEM005 respectively, due to changes in the wording and points for DEM002, and changes in the timeframe for DEM003.
- CKD001 is now numbered CKD005 following a change in wording
- OB001 is now numbered OB002 following a change in the age group to which the indicator applies
- There have been no changes to the number of points available, or to the number or definition of any indicators for 2016-17 or 2017-18, as compared with 2015-16.
The clinical codes used to define the learning disabilities register changed significantly for QOF 2018-19, meaning that the register (and associated recorded disease prevalence) is not comparable with previous years. The indicator ID has changed from LD003 to LD004 as a result, although the description remains the same.