The Quality and Outcomes Framework (QOF) is a key part of the General Medical Services (GMS) contract, introduced on 1st April 2004. It is a system offering financial incentives to GP practices to encourage them to provide good quality care to their patients. These incentives can then be used to help fund work to further improve the quality of health care delivered. It is about rewarding contractors for good practice by measuring what they do against a range of evidence-based indicators, with points and payments awarded according to the level of achievement.
The QOF pays special attention to the care of patients with chronic conditions such as coronary heart disease (CHD), diabetes and cancer, by offering strong incentives for these particular areas of care (clinical domains). For example, for CHD practices are rewarded for diagnosing angina in patients and referring them for specialist assessment, whilst the ongoing management of diabetes is rewarded if specialist blood tests are carried out on a regular basis.
At the same time attention is focussed on more organisational-related issues (organisational domains) such as the management of medicines, information for patients, staff education and training, management of records and access to patient services. For example, rewards are given for meeting specific targets in the issuing of repeat prescriptions and for the training/updating of staff's life-support skills. Extra 'points' can be earned by a practice carrying out an annual patient survey and keeping the patients informed of organisational changes within the primary care trust (PCT).
The main bulk of the QOF information is collected through an automated process called the Quality Management and Analysis System (QMAS). The 'data' is collected from patients' electronic records through the use of special codes, called READ codes. QMAS then works out the GP practice's 'performance' and the points it has 'earned' and passes this information to the practice and its managing trust (the PCT) on request.
Other information is collected by a combination of an annual visit to the practice by a special team, and an extensive self-assessment where the practice must include examples of many of their policies and procedures.
For more information and guidance on the national QOF review process visit the
Department of Health website
.
