QOF to become more 'streamlined and focused' - The Changes to QOF in 2023/24

The Quality and Outcomes Framework (QOF) is an incentive scheme for GP practices in the UK, which rewards them for delivering high-quality care to patients. QOF has been in place since 2004 and has undergone many changes over the years. In 2023/24, there will be significant changes to QOF, which will streamline the system and make it more focused.

One of the key changes to QOF in 2023/24 is the income protection of all register indicators. This means that practices will continue to receive funding for all of the indicators on their register, regardless of how well they perform. This change will release £97m of funding, which can be used to invest in improving patient care.

The number of indicators in QOF will also be reduced from 74 to 55, which represents a reduction of 25%. This will make the system more streamlined and easier for practices to manage. The funding for QOF will be paid to practices based on their 2022/23 performance, once the outturn is finalised.

Other revisions to QOF include:

• Atrial Fibrillation indicator AF007 will be retired and replaced with a new indicator, AF008 – the percentage of patients on the QOF Atrial Fibrillation register and with a CHA2DS2-VASc score of 2 or more, who were prescribed a direct-acting oral anticoagulant (DOAC), or, where a DOAC was declined or clinically unsuitable, a Vitamin K antagonist. This will carry 12 points, with a lower threshold target of 70% and upper threshold of 95%. This new indicator is similar to one from this year’s Investment and Impact Fund (IIF), CVD-05.
• Two new cholesterol indicators will be added to QOF worth 30 points, and £36m in funds.
• There will also be a new overarching mental health indicator.
• The above additions will be funded by retiring indicator RA002 (the percentage of patients with rheumatoid arthritis on the register, who have had a face-to-face review in the preceding 12 months) and reducing the value of DEM004 (annual dementia review).
• The mode of review of DEM004 will also be amended ‘to be determined through shared decision-making with the patient’.
• There will also be other small changes to indicator wordings and values in 2023/24.

In addition to these changes, the QOF QI modules in 2023/24 will focus on workforce and wellbeing, as well as the optimisation of demand and capacity management in general practice. These modules will help practices improve their efficiency and effectiveness, which will ultimately lead to better patient outcomes. This will include ‘an emphasis on using data to analyse potentially avoidable appointments and build on care navigation and use of wider workforce or local services to reduce pressure on general practice,’ said NHS England.

It is important to note that these changes to QOF are not permanent. Work will be undertaken during 2023/24 to review QOF in its current form with the aim of making it more streamlined and focused. The profession, patients, and the broader system will be consulted to determine the most appropriate form of QOF for 2024/25 and beyond.

In conclusion, the changes to QOF in 2023/24 will streamline the system and make it more focused on delivering high-quality care to patients. The income protection of all register indicators and the reduction in the number of indicators will release funding for practices to invest in improving patient care. The new indicators and QI modules will help practices to improve their efficiency and effectiveness, which will ultimately lead to better patient outcomes.