From April 2009, the National Institute for Health and Care Excellence (NICE) became responsible for developing a menu of recommended changes to QOF. The menu is then used to inform negotiations between NHS Employers (on behalf of NHS England) and the BMA General Practitioners Committee (GPC) on changes to QOF.
Role of NHS Employers
NHS Employers role in the new QOF process is to negotiate changes to QOF with the GPC. The negotiating process begins following the publication of the NICE menu of recommended changes. Discussions are based on the menu, the relevant NICE guidance and associated evidence published by NICE.
The outcome of negotiations between NHS Employers and the GPC informs the National QOF. NHS Employers and the GPC agree which indicators should be applied in England and also agree what point value and threshold should apply to the indicators. Practice payments are then calculated based on the number of points achieved.
NHS Employers and the GPC are also responsible for publishing the National QOF guidance following any changes.
Role of NICE
NICE's role includes managing an independent and transparent approach to developing the QOF clinical and health improvement indicators, following a public consultation. Our QOF homepage has more details on the QOF domains and indicators.
NICE's role also includes prioritising areas for new indicator development, developing and selecting indicators for inclusion on the NICE menu of recommendations and consulting with individuals and stakeholder groups. For further details on the role of NICE, please see the NICE website.
Developing QOF 2004
The QOF was first introduced as part of the new General Medical Services (nGMS) contract in 2004. It represented a radical modernisation of the GMS contract and for the first time, it linked payments to improvements in the quality of patient care.
Through QOF, the GMS contract gave practices the opportunity to get additional funding for delivering quality care, with extra incentives to encourage even higher standards.
QOF payments are based on achievement and specific calculations, more information and background to these can be found on the
Developing QOF and QOF 2004 fact sheet.