Quality and Outcomes Framework, 2023-24

Payment protection (i.e. payments were made to practices irrespective of activity recorded for indicators in that year) which was in place for two reporting years (2020-21 and 2021-22) was removed for the 2022-23 reporting year and reintroduced for some indicators in the 2023-24 reporting year. More information on payment protection can be found in the 'Technical annex'.

_{Obesity prevalence is only shown for 2023-24 due to changes in register definition. Depression prevalence is not shown due to changes in the register definition, which only captures new incidences of depression. Consequently, disease prevalence cannot be calculated or compared to 2022-23.} 

^{Note: prevalence rates for 2022-23 have been recalculated only using practices for which data is available for both reporting years.}

Overall, the greatest change in QOF recorded prevalence was for non-diabetic hyperglycaemia, which increased from 7.1% in 2022-23 to 8.2% in 2023-24. An increase of between 0.8 and 1.5 percentage points is demonstrated across all regions in England.

^{Note: prevalence rates for 2022-23 have been recalculated only using practices for which data is available for both reporting years.}

The QOF recorded prevalence for hypertension exhibits the greatest range by region, with the lowest rate in London (11.1%) and the highest rate in the North East and Yorkshire (16.2%).

^{Note: prevalence rates for 2022-23 have been recalculated only using practices for which data is available for both reporting years.}

Obesity prevalence is only shown for 2023-24 due to changes in the register definition.

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 2023-24, overall achievement ranged from 62.8% for the vaccination and immunisation indicator group, to 100.0% for the obesity indicator group.

_{2022-23 achievement rates are not shown for indicator groups in the quality improvement domain (optimise use of staff capacity, optimise use of staff capacity, workforce and wellbeing) and cholesterol control and lipid management as these indicator groups are new to 2023-24.} 

^{Note: payment protection was applied to some indicators in 2023-24  but not in 2022-23,  this may affect QOF activity and/or its recording for these years.}

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 chronic obstructive pulmonary disease (COPD) indicator group had the highest PCA rate (28.7%), whilst the smoking (15+) had the lowest (1.7%).