An incentive scheme for general practices allowing them to earn points that generate a proportion of practice income. Although the scheme is voluntary, it is such an important source of income that few if any practices do not participate. Much of the day to day work required to collect QOF data and meet QOF targets is performed by practice nurses. The QOF was introduced in 2004. It comprises a number of quality standards or ‘indicators’ relating to two categories, or ‘domains’

• Clinical, covering areas such as coronary heart disease, heart failure and hypertension, and
• Public health, which includes health improvement subject areas e.g. smoking, obesity, plus cervical screening and contraceptive services

Each year the Framework is updated, and indicators may be added or retired. NICE is responsible for developing clinical and public health domain indicators, but the QOF is determined by the Government usually following negotiation with the BMA’s GP Committee. There are variations in the indicators and thresholds for each of the UK nations, so check the appropriate guidance for details. (NI guidance for 2014-15 still awaited, as of July 2014).