Quality and Outcomes Framework, 2022-23

Due to the impact of the COVID-19 pandemic on activity in general practice, QOF implementation was changed for the reporting years 2020-21 and 2021-22; 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 was removed for the 2022-23 reporting year (i.e. payments made to practices were dependant on activity recorded for indicators in that year). More information on payment protection can be found in the 'Technical annex'.

The increase of between 1 and 2 percentage points in QOF recorded prevalence of obesity is demonstrated across all regions in England.

_{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.}

The QOF recorded prevalence of depression exhibits the greatest range by region, with the lowest rate in London (9.5%) and the highest rate in the North West (16.4%).

_{Note: prevalence rates for 2021-22 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. Payment protection is no longer in place for QOF 2022-23, which may affect the level of achievement. Further details are available in the 'Technical annex'.

In 2022-23, overall achievement ranged from 55.5% for the vaccination and immunisation indicator group, to 100.0% for the obesity indicator group.

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 (24.1%), whilst the prescription drug dependency (18+) management information had the lowest (0.6%).