Quality and Outcomes Framework, 2021-22

Due to the impact of the COVID-19 pandemic on activity in general practice, QOF implementation was changed for the 2020-21 reporting year; the majority of QOF indicators were income protected (i.e. payments were made to practices irrespective of activity recorded for indicators in that year). Payment protection continues to be in place for QOF 2021-22. Further information on the income protection measures applied to QOF can be found on the NHS England and Improvement website.

The increase in QOF recorded prevalence of obesity is likely to be due to the increase in face-to-face consultations after the pandemic; in order to be included on the obesity register, a patient must have a BMI of 30 or more recorded in the 12 months up to and including the reporting period end date.

This increase in QOF recorded prevalence is demonstrated across all regions in England.

The QOF recorded prevalence of depression exhibits the greatest range by region, with the lowest rate in London (9.0%) and the highest rate in the North West (15.5%).

_{Note: prevalence rates for 2020-21 have been recalculated using only those practices for which data are available for both reporting years.}

QOF achievement refers to the percentage of available QOF points attained. Points are associated with each indicator, and each indicator specifies a level of clinical care. A threshold is set in respect of the provision of this clinical care to patients on the relevant QOF register - for many indicators, a practice must provide the specified clinical care to 90% of patients on the relevant register in order to achieve the full points available for the indicator. Further details are available in the technical annex.

In 2021-22, overall achievement ranged from 52.2% for the vaccination and immunisation indicator group, to 100.0% for the cancer, care of people with learning disabilities, early cancer diagnosis and obesity indicator groups.

_{**Non-diabetic hyperglycaemia (NDH) indicator group has a 0 (zero) points allocation which is reflected in the chart.}

The average total achievement score for GP practices in 2021-22 was 582.4 (out of a maximum of 635).

The proportion of practices achieving the maximum score decreased to 1.5% in 2021-22, from 6.2% in 2020-21.

Personalised care adjustment (PCA) rates reflect the percentage of patients who are not included when determining QOF achievement. Examples of PCAs include patient refusal of treatment, GP advice that two types of treatment should not be administered simultaneously, or a patient registration or diagnosis occurring within three months of the end of the reporting year (full details are available in the technical annex).

The Depression indicator group had the highest PCA rate (18.9%), whilst the blood pressure indicator had the lowest (0.7%).