Quality and Outcomes Framework (QOF)
Overview
QOF payments
CQRS uses information collected by General Practice Extraction Service (GPES) on behalf of NHS England about General Practice (GP) achievement under the Quality and Outcomes Framework (QOF). The information is used by CQRS to calculate GP achievement payments values for the current financial year, and to set aspiration payment values for the following year. QOF reporting collections are run throughout the year, but these are not used to calculate the payment made at the end of the financial year.
Reporting collections
QOF reporting collections run throughout the year, with the information made available in CQRS afterwards. This allows practices to check it against the information in their clinical systems throughout the year and address potential issues in advance of the year end period.
If collected information appears incorrect:
- contact your clinical system supplier to check what information was collected
- gather evidence to demonstrate correct information
- contact your commissioner
We advise keeping CQRS final QOF achievement submission reports for future reference. QOF information is kept on CQRS for at least 5 years.
If the circumstances of your practice are due to change (closure, merge or split), please check with your GP practice system supplier to investigate if they will be sending an automated QOF extract for your practice for 31st March that will correctly reflect the state of your GP practice before the change takes place. If an automated collection that reflects the situation that you expect is being sent, no further actions are required beyond the standard year-end actions.
If an automated extract will not be supplied by your GP practice system supplier, you will need to manually enter your QOF achievement data.
For a step-by-step guide, refer to the Full Manual Entry Guide.
Quality and Outcomes Framework (QOF) Year End Checklist
This guide describes the actions required from GP practices in preparation for the year-end data extract for Quality and Outcomes Framework (QOF).
1. Check performance
Check your practice’s QOF performance on your clinical system.
If necessary, take action to improve before submitting.
If required, ask your commissioner to submit updated Contractor Registered Population (CRP) for your practice to the CQRS Service Desk before 28 February 2025.
If necessary, take action to improve before submitting.
If required, ask your commissioner to submit updated Contractor Registered Population (CRP) for your practice to the CQRS Service Desk before 28 February 2025.
2. Get set up on Calculating Quality Reporting System (CQRS)
If you already have a CQRS log in, check that you can log in to the system and ensure your password and security questions are up to date.
If not already set up, ask your Commissioning Organisation to register a member of staff as a CQRS user/administrator, for example your practice manager.
Ask your user/administrator to set up logins for all staff members submitting QOF.
Ask all staff members submitting QOF data to check that they can log in.
If not already set up, ask your Commissioning Organisation to register a member of staff as a CQRS user/administrator, for example your practice manager.
Ask your user/administrator to set up logins for all staff members submitting QOF.
Ask all staff members submitting QOF data to check that they can log in.
3. Participate in Quality and Outcomes Framework (QOF) 2024/25 to receive achievement payments
Participate in QOF 2024/25 on CQRS before end of day 30th March 2025.
For a step-by-step guide, refer to Module 4 and Module 5 in our CQRS Training area
Contact your commissioning organisation if you have not received an offer of participation.
For a step-by-step guide, refer to Module 4 and Module 5 in our CQRS Training area
Contact your commissioning organisation if you have not received an offer of participation.
4. Participate in Quality and Outcomes Framework (QOF) 2025/26 to receive aspiration payments
Participate in QOF 2025/26 on CQRS before end of day 30th March 2025 once it has been offered by your commissioner. Practices are expected to see the offer in CQRS from 12th March 2025. Find out how to agree to participate this by using the guide on our training site.
5. Manual Indicator Submission
If a practice does have a QOF 23/24 achievement calculation or has merged and the remaining practice does have a QOF 23/24 achievement calculation:
Manual entry of indicators is not required for the Quality Improvement (QI) indicators in 24/25. Data from QOF 23/24 will be copied over on the 11th March 2025. Changes to the indicators are possible to be made by commissioners only, however the changes will not be income protected.
If a practice does not have a QOF 23/24 achievement calculation (for example if a practice has been issued a new practice code) or has merged, and the remaining practice does not have a QOF 23/24 achievement:
An off system payment will need to be made for QOF 24/25 as the practice will be missing all income protected indicators. At year end, practices with missing data for these manual indicators will be identified and further communications will be provided to individual ICB’s
Manual entry of indicators is not required for the Quality Improvement (QI) indicators in 24/25. Data from QOF 23/24 will be copied over on the 11th March 2025. Changes to the indicators are possible to be made by commissioners only, however the changes will not be income protected.
If a practice does not have a QOF 23/24 achievement calculation (for example if a practice has been issued a new practice code) or has merged, and the remaining practice does not have a QOF 23/24 achievement:
An off system payment will need to be made for QOF 24/25 as the practice will be missing all income protected indicators. At year end, practices with missing data for these manual indicators will be identified and further communications will be provided to individual ICB’s
Related links
For further information visit the GP Contract page on the NHS England website.
Calculating Quality Reporting Service (CQRS) training is available. Log in details are not required.
The training provides a step-by-step guide for performing key processes in CQRS. This includes a guide to submitting and declaring achievement for payment for each of the Enhanced Services currently available on CQRS.
Quality and Outcomes Framework (QOF) Frequently Asked Questions (FAQs)
This page features Frequently Asked Questions (FAQs) about the Quality and Outcomes Framework (QOF).
What is the national average practice list size that will be used in the re-calculations for QOF achievement?
The national average practice list size used for the 24/25 achievement calculation is 9964.
The national average practice list size used for the 25/26 achievement calculation is yet to be confirmed by NHSE.
The national average practice list size used for the 25/26 achievement calculation is yet to be confirmed by NHSE.
What is the value of a QOF point?
The value of a QOF point for 2024/25 is £220.62
The value of a QOF point for 2025/26 is yet to be confirmed by NHSE.
The value of a QOF point for 2025/26 is yet to be confirmed by NHSE.
Which manual indicators do I need to complete on CQRS?
Manual entry of indicators is not required for the following indicators in 2024/2025, unless you are one of the small number of organisations that must enter data manually for all indicators.
QI013
The contractor can demonstrate continuous quality improvement activity focused upon workforce and wellbeing as specified in the QOF guidance
QI014
The contractor has participated in network activity to regularly share and discuss learning from quality improvement activity focused on workforce and wellbeing as specified in current QOF guidance. This would entail attending two primary care network meetings, at the start and towards the end of QI activity. If a practice is not within a PCN, the expectation is that two meetings would be held locally with other practices
QI016
The contractor can demonstrate that it has in place a recognised and validated approach to understanding demand/activity, capacity and appointment data and has made improvements to data quality to better reflect practice work.
QI017
The contractor can demonstrate that it has utilised demand and capacity data to inform operational decisions and plan for demand and capacity matching .
QI018
The contractor has participated in network activity to review the smart cards of all staff employed under the Additional Roles Reimbursement Scheme (ARRS), to ensure that the staff role assigned on their smart card aligns with the role they are employed under within the ARRS.
QI019
The contractor can demonstrate improvement in reducing avoidable appointments by:
1. Using BI tools, if available and practice collected data where not, to understand the practice activity including variations over the days of the week, time of day and time of year.
2. Developing an understanding of the telephone queue either by extracting data from their cloud-based telephony system or asking staff to collect data over a period.
3. Using that data to understand their peaks of activity and better matching their capacity to their demand by, for instance, reviewing rotas.
4. Using improvement techniques described in the Primary Care Transformation Team’s webinar series on Demand and Capacity which provides practical advice and guidance.
5. Referencing the Royal College of General Practitioner’s 6 steps to start to improve delivering continuity of care from their Continuity Toolkit for those who need it and adapting to suit the needs of the practice.
QI013
The contractor can demonstrate continuous quality improvement activity focused upon workforce and wellbeing as specified in the QOF guidance
QI014
The contractor has participated in network activity to regularly share and discuss learning from quality improvement activity focused on workforce and wellbeing as specified in current QOF guidance. This would entail attending two primary care network meetings, at the start and towards the end of QI activity. If a practice is not within a PCN, the expectation is that two meetings would be held locally with other practices
QI016
The contractor can demonstrate that it has in place a recognised and validated approach to understanding demand/activity, capacity and appointment data and has made improvements to data quality to better reflect practice work.
QI017
The contractor can demonstrate that it has utilised demand and capacity data to inform operational decisions and plan for demand and capacity matching .
QI018
The contractor has participated in network activity to review the smart cards of all staff employed under the Additional Roles Reimbursement Scheme (ARRS), to ensure that the staff role assigned on their smart card aligns with the role they are employed under within the ARRS.
QI019
The contractor can demonstrate improvement in reducing avoidable appointments by:
1. Using BI tools, if available and practice collected data where not, to understand the practice activity including variations over the days of the week, time of day and time of year.
2. Developing an understanding of the telephone queue either by extracting data from their cloud-based telephony system or asking staff to collect data over a period.
3. Using that data to understand their peaks of activity and better matching their capacity to their demand by, for instance, reviewing rotas.
4. Using improvement techniques described in the Primary Care Transformation Team’s webinar series on Demand and Capacity which provides practical advice and guidance.
5. Referencing the Royal College of General Practitioner’s 6 steps to start to improve delivering continuity of care from their Continuity Toolkit for those who need it and adapting to suit the needs of the practice.
Do I have to manually enter all data for QOF?
Income protection will be used to calculate QOF 24/25 achievement in CQRS. The calculation will use the previous performance for QOF 23/24 to calculate the achievement for the income protected indicators. Please see QOF framework guidance for further details.
Please see the scenarios below for guidance for your practices:
1. If a practice does have a QOF 23/24 achievement calculation:
Manual entry of indicators is not required for the below Quality Improvement (QI) indicators in 24/25. Data from QOF 23/24 will be copied over on the 11th March 2025. Changes to the indicators are possible to be made by commissioners only, however the changes will not be income protected.
2. If a practice does not have a QOF 23/24 achievement calculation (for example if a practice has been issued a new practice code):
An off system payment will need to be made for QOF 24/25 as the practice will be missing all income protected indicators
At year end, practices with missing data for these manual indicators will be identified and further communications will be provided to individual ICB’s
3. If a practice has merged and the remaining practice does have a QOF 23/24 achievement calculation
Manual entry of indicators is not required for the below QI indicators in 24/25. Data from QOF 23/24 will be copied over on the 11th March 2025. Changes to the indicators are possible to be made by commissioners only, however the changes will not be income protected.
4. If a practice has merged, and the remaining practice does not have a QOF 23/24 achievement
An off system payment will need to be made for QOF 24/25 as the practice will be missing all income protected indicators
At year end, practices with missing data for these manual indicators will be identified and further communications will be provided to individual ICB’s
Other Income Protected Indicators
No action is currently required for these indicators (QOF framework guidance).
For some practices it is not possible to collect QOF year-end achievement information automatically. These practices will be informed by the CSU Collaborative, their commissioner and/or their clinical system supplier and will need to enter this information into CQRS manually. Payment cannot be made to these practices until this is done.
Practices that need to manually enter QOF information include:
Shared practices: Practices sharing a clinical system need to separately enter their achievement manually as CQRS only collects automatically for one practice.
Closing practices: Practices closing before the end of the financial year need to enter QOF achievement information manually into CQRS. Data must be entered up to the date that they close. Any manual data submitted for a closed practice prior to 11th March 2025 will not be subject to income protection and will calculate based on the submitted data. Any manual data submitted after 11th March 2025 will be subject to income protection.
Others: Practices that cannot have information collected automatically for other reasons need to enter QOF achievement information into CQRS manually.
If an automated extract will not be supplied by your GP practice system supplier, you will need to manually enter your QOF 2024/25 data.
If achievement is not calculated for QOF 24/25, further instructions will be communicated to the relevant ICB’s at the time of calculation. At year end, practices with missing data for these manual indicators will be identified and further communications will be provided.
Please see the scenarios below for guidance for your practices:
1. If a practice does have a QOF 23/24 achievement calculation:
Manual entry of indicators is not required for the below Quality Improvement (QI) indicators in 24/25. Data from QOF 23/24 will be copied over on the 11th March 2025. Changes to the indicators are possible to be made by commissioners only, however the changes will not be income protected.
2. If a practice does not have a QOF 23/24 achievement calculation (for example if a practice has been issued a new practice code):
An off system payment will need to be made for QOF 24/25 as the practice will be missing all income protected indicators
At year end, practices with missing data for these manual indicators will be identified and further communications will be provided to individual ICB’s
3. If a practice has merged and the remaining practice does have a QOF 23/24 achievement calculation
Manual entry of indicators is not required for the below QI indicators in 24/25. Data from QOF 23/24 will be copied over on the 11th March 2025. Changes to the indicators are possible to be made by commissioners only, however the changes will not be income protected.
4. If a practice has merged, and the remaining practice does not have a QOF 23/24 achievement
An off system payment will need to be made for QOF 24/25 as the practice will be missing all income protected indicators
At year end, practices with missing data for these manual indicators will be identified and further communications will be provided to individual ICB’s
Other Income Protected Indicators
No action is currently required for these indicators (QOF framework guidance).
For some practices it is not possible to collect QOF year-end achievement information automatically. These practices will be informed by the CSU Collaborative, their commissioner and/or their clinical system supplier and will need to enter this information into CQRS manually. Payment cannot be made to these practices until this is done.
Practices that need to manually enter QOF information include:
Shared practices: Practices sharing a clinical system need to separately enter their achievement manually as CQRS only collects automatically for one practice.
Closing practices: Practices closing before the end of the financial year need to enter QOF achievement information manually into CQRS. Data must be entered up to the date that they close. Any manual data submitted for a closed practice prior to 11th March 2025 will not be subject to income protection and will calculate based on the submitted data. Any manual data submitted after 11th March 2025 will be subject to income protection.
Others: Practices that cannot have information collected automatically for other reasons need to enter QOF achievement information into CQRS manually.
If an automated extract will not be supplied by your GP practice system supplier, you will need to manually enter your QOF 2024/25 data.
If achievement is not calculated for QOF 24/25, further instructions will be communicated to the relevant ICB’s at the time of calculation. At year end, practices with missing data for these manual indicators will be identified and further communications will be provided.
What is required if a GP practice is closing before 31 March 2025?
If your GP practice is closing before 31 March, please perform the following actions:
Check the GP practice closure date on CQRS. If it is not correct, contact your commissioning organisation, who will need to update this via PCSE. If it has been updated.
Check that your participation in QOF ends on the same date that your GP practice closes. Please be advised this can only be checked by your commissioners.
Manually enter data for QOF achievement. Ensure that you set the date in CQRS for the period that you are entering data for. This should be the same as the practice closure date.
Check the GP practice closure date on CQRS. If it is not correct, contact your commissioning organisation, who will need to update this via PCSE. If it has been updated.
Check that your participation in QOF ends on the same date that your GP practice closes. Please be advised this can only be checked by your commissioners.
Manually enter data for QOF achievement. Ensure that you set the date in CQRS for the period that you are entering data for. This should be the same as the practice closure date.
What do I need to do if a GP practice is merging or splitting before 31 March 2025?
CQRS will not be provided with the information to correctly calculate QOF achievement for the merged or split section of a GP practice.
CQRS will calculate QOF achievement as if the GP practice has not undergone a split or merge.
Your commissioning organisation will need to manually determine the impact of the merge/split on the QOF payments and apply these through the PCSE system.
CQRS will calculate QOF achievement as if the GP practice has not undergone a split or merge.
Your commissioning organisation will need to manually determine the impact of the merge/split on the QOF payments and apply these through the PCSE system.
What do I need to do if a practice is closing, merging or splitting on 31 March 2025 or from 1 April 2025? Is the commissioning organisation required to sign off QOF aspiration payments?
Practices will need to confirm with their clinical system that they will send the QOF data for 31st March to ensure the work carried out prior to the closure/merger/split is reflected. If the clinical system are set up to send this data for 31st March, no further action is required. If the clinical system closes down the extracts prior to 31st March, the practice will need to manually enter their QOF data as this will not extract.
No. The aspiration payment for any practices that we have achievement data for will be calculated following the QOF achievement calculation and release of payment files. The exact payment date will depend on local arrangements.
No. The aspiration payment for any practices that we have achievement data for will be calculated following the QOF achievement calculation and release of payment files. The exact payment date will depend on local arrangements.
How will I know if I will receive my estimated QOF aspiration payment?
Standard aspiration payments will be applied where practices have fully completed entry of data. This includes:
– Where all information has been extracted and no manual entry is required
– Where data has been extracted and required manual entry has been completed
– Where all data has been manually entered. Practices where automated data is available and manual indicators have been entered where necessary.
Estimated aspiration payments
Estimated aspiration payments will be available where data in CQRS is incomplete. This includes:
– Practices where automated data is available from GPES, but the manual indicators have not been entered
– Practices where the automated data is not available for the year end extract from GPES but have entered data for the four required manual indicators
– Practices for which no data is available, from GPES or manual.
Once all required QOF data is supplied, the standard aspiration will be calculated, and an adjustment made.
– Where all information has been extracted and no manual entry is required
– Where data has been extracted and required manual entry has been completed
– Where all data has been manually entered. Practices where automated data is available and manual indicators have been entered where necessary.
Estimated aspiration payments
Estimated aspiration payments will be available where data in CQRS is incomplete. This includes:
– Practices where automated data is available from GPES, but the manual indicators have not been entered
– Practices where the automated data is not available for the year end extract from GPES but have entered data for the four required manual indicators
– Practices for which no data is available, from GPES or manual.
Once all required QOF data is supplied, the standard aspiration will be calculated, and an adjustment made.
What happens to aspiration payments for practices that have merged?
Before undertaking any action, contact your commissioning organisation for advice – they may have an established process in place.
There is some reconciliation work required to ensure that practices are paid the appropriate aspiration which takes into account the QOF achievement for patients that merged into the practice during the QOF year.
To complete the reconciliation:
– provide updated CRP figures to the CQRS team so that CQRS can be updated to reflect the new practice list size including the merged patients
– the extract for QOF year-end will produce an interim achievement figure. This will be an inflated figure as it includes the new patients. Do not declare this figure.
– CQRS will calculate an interim aspiration figure – this will also be an inflated figure due to the list size adjustment
– the practice will need to go through and balance the achievement by checking each indicator and removing the counts for the patients that belonged to the closed practice up to the closing date of the practice. Once the counts for the patients that belong to the closed practice have been removed, the practice can evidence this to the commissioning organisation and declare the achievement.
Please note that adjustments applied as part of income protection do not need to be amended.
– aspiration payments will then be adjusted for the rest of the financial year to ensure that the right amount is paid. This is likely to be less than the initial payments.
There is some reconciliation work required to ensure that practices are paid the appropriate aspiration which takes into account the QOF achievement for patients that merged into the practice during the QOF year.
To complete the reconciliation:
– provide updated CRP figures to the CQRS team so that CQRS can be updated to reflect the new practice list size including the merged patients
– the extract for QOF year-end will produce an interim achievement figure. This will be an inflated figure as it includes the new patients. Do not declare this figure.
– CQRS will calculate an interim aspiration figure – this will also be an inflated figure due to the list size adjustment
– the practice will need to go through and balance the achievement by checking each indicator and removing the counts for the patients that belonged to the closed practice up to the closing date of the practice. Once the counts for the patients that belong to the closed practice have been removed, the practice can evidence this to the commissioning organisation and declare the achievement.
Please note that adjustments applied as part of income protection do not need to be amended.
– aspiration payments will then be adjusted for the rest of the financial year to ensure that the right amount is paid. This is likely to be less than the initial payments.
How do I review my QOF achievement data on CQRS?
Following the completion of the calculation (on or after 8th April), you will be able to:
– log in to CQRS
– select the Reports Tab (it should default to Achievement)
– select the report Achievement Summary
Then, select the parameters:
– select the Financial Year option and set the achievement year
– select the Quality Service option and set to Quality and Outcomes Framework for the relevant year
– select the achievement date 31/03/2025
– select the option to Run Report
The QOF achievement data for your GP practice should then be displayed. Initially this will show the domains, the total achievement, any adjustments, CPI calculation and Contract duration. You can then access further information within each domain by clicking on it. This will display the Indicator Groups. Clicking in each of the indicators will display further information, including how the QOF achievement has been calculated.
– log in to CQRS
– select the Reports Tab (it should default to Achievement)
– select the report Achievement Summary
Then, select the parameters:
– select the Financial Year option and set the achievement year
– select the Quality Service option and set to Quality and Outcomes Framework for the relevant year
– select the achievement date 31/03/2025
– select the option to Run Report
The QOF achievement data for your GP practice should then be displayed. Initially this will show the domains, the total achievement, any adjustments, CPI calculation and Contract duration. You can then access further information within each domain by clicking on it. This will display the Indicator Groups. Clicking in each of the indicators will display further information, including how the QOF achievement has been calculated.
What is CPI on the achievement summary report?
The contractor population index (CPI) adjustment has been included in the QOF calculation since 2004. A description can be found in the Statement of Financial Entitlements (SFE) and in all previous versions available on the government’s website. The CPI calculation was performed on all historical QOF payments on the QMAS system, and now CQRS, in accordance with the details in the SFE.
https://www.gov.uk/government/publications/nhs-primary-medical-services-directions-2013
CPI adjustment is calculated on the practice list size divided by the national average.
https://www.gov.uk/government/publications/nhs-primary-medical-services-directions-2013
CPI adjustment is calculated on the practice list size divided by the national average.
What reports can I use to confirm which practices have completed their manual data entry on CQRS for QOF?
Two reports are available for commissioners under the Data Entry tab.
1. Data Entry Quality Service Data Complete
Select the Quality Service relevant to QOF for the achievement year and click Run Report. The report will list all GP practices within your commissioning area who are participating in QOF for that year and have completed their manual indicators.
2. Data Entry Quality Service Data Missing
Select the Quality Service ‘QOF’ and click Run Report. The report will list all GP practices within your commissioning area who are participating in QOF but have not completed their manual indicators.
1. Data Entry Quality Service Data Complete
Select the Quality Service relevant to QOF for the achievement year and click Run Report. The report will list all GP practices within your commissioning area who are participating in QOF for that year and have completed their manual indicators.
2. Data Entry Quality Service Data Missing
Select the Quality Service ‘QOF’ and click Run Report. The report will list all GP practices within your commissioning area who are participating in QOF but have not completed their manual indicators.
When will I see QOF achievement data in CQRS?
Achievement data will start becoming visible in CQRS following the completion of the calculation (on or after 8th April). Some practices may see this data a few days later if their data is collected via additional extractions.
In line with previous years, once the achievement payment has been approved, CQRS will adjust the standard aspiration as required to reflect the actual QOF achievement.
In line with previous years, once the achievement payment has been approved, CQRS will adjust the standard aspiration as required to reflect the actual QOF achievement.
What should a GP practice do if they don’t agree with the achievement data they see in CQRS?
If your practice disagrees with the achievement payment values calculated in CQRS:
– assemble evidence in support of the disagreement and inform your commissioning organisation
– if the numerator, denominator or exceptions are incorrect, contact your GP system supplier and obtain the relevant evidence
– provide full evidence to your commissioning organisation. They will be required to review the evidence and negotiate an adjustment
The CQRS team cannot resolve disputes or update your data in CQRS. Amendments to data as a result disputes and queries are actioned by your commissioning organisation.
– assemble evidence in support of the disagreement and inform your commissioning organisation
– if the numerator, denominator or exceptions are incorrect, contact your GP system supplier and obtain the relevant evidence
– provide full evidence to your commissioning organisation. They will be required to review the evidence and negotiate an adjustment
The CQRS team cannot resolve disputes or update your data in CQRS. Amendments to data as a result disputes and queries are actioned by your commissioning organisation.
I have calculated the QOF figure for my practice outside of the CQRS system – is the CQRS figure incorrect?
The calculated figure is based on the data extracted from your GP system. The calculation in CQRS is rigorously tested and we are confident that the calculation method is correct. If it is not what you are expecting to see, then you need to query this with your GP system supplier in the first instance.
The calculation includes several factors, so it is unlikely that a locally calculated figure will match the figure in the system.
Indicator calculation:
Actual achievement/Maximum potential achievement x Points available for indicator x Value of a QOF point x Adjustment prevalence (patient set/CRP)/National prevalence (average prevalence)
The calculation includes several factors, so it is unlikely that a locally calculated figure will match the figure in the system.
Indicator calculation:
Actual achievement/Maximum potential achievement x Points available for indicator x Value of a QOF point x Adjustment prevalence (patient set/CRP)/National prevalence (average prevalence)
Will a GP practice need to retain clinical system audit reports of the final QOF achievement submission reports?
GPs are encouraged to retain clinical system audit reports. This supports any post verification work and assists reconciliation against the final CQRS report. CQRS will retain QOF data for five years.
Page updated: 20 February 2025