Report of the Review of the Quality and Outcomes Framework in England

A review of the Quality and Outcomes Framework (QOF) was agreed with the General Practitioners Committee of the BMA as part of the 2017/18 contract negotiations, and was also a commitment within the Next Steps on the five Year Forward View. This report presents the findings of that review, with the aim of stimulating discussion about how the QOF can be developed to support good quality care into the future. It reflects extensive contributions of an Advisory Group of senior stakeholders and has also drawn widely on expertise in the field, particularly that of members of our Technical Working Group, and a series of reference groups with patients, practice staff and commissioners

The Review concludes that there are aspects of QOF which are both valued and valuable, but there is a need to refresh the scheme to support a wider view of high quality care and to align better with professional values.

The three objectives that NHS England considered highest priority for a reformed scheme, following discussion with the Advisory Group, are that it:

  1. Delivers better patient care, particularly by enabling more holistic person-centred care, and incentivises on-going improvement
  2. Supports stability and sustainability in general practice, by creating space for professionalism, at a time when workload is high and the profession is reporting high levels of stress and concern
  3. Supports practices to move into a role in which they can better impact demand on the wider system, and so optimise the use of limited resources

The Report presents potential changes that would deliver these objectives. QOF forms part of the GMS contract, and as such proposed changes to QOF are subject to negotiations with the British Medical Association’s General Practitioners Committee. NHS England looks forward to continue to work with GPC, who have been key contributors to this review.

An annex with an indicator assessment methodology and its application to current indicators has also been published.

Comments on this report may be submitted to england.qofreview@nhs.net before 31 August 2018