United Kingdom — Quality and Outcomes Framework
QOF Performance Optimization
Maximizing Your Quality Outcomes Framework Income
QOF 2024/25 offers 635 points at an average value of approximately £190 per point — a maximum potential income of around £120,000 per year for an average practice. Most practices leave points on the table every year. Vizier shows you exactly where they are and what it takes to recover them.
635
Total QOF points 2024/25
~£190
Average value per point
~£120K
Maximum QOF income (average list)
20%+
Exception rate that triggers scrutiny
How Vizier Optimizes Your QOF Score
Exception Reporting Rate Monitoring
Exception reporting allows practices to exclude patients from indicators for clinical or administrative reasons. A normal exception rate is 10–15%. Rates above 20% on any individual indicator trigger NHS scrutiny. Vizier monitors your exception rates in real time and alerts when rates approach the review threshold — protecting your income and compliance standing.
Incorrect Exception Identification
Patients are sometimes exception-reported incorrectly — either due to data entry error, system coding issues, or misunderstanding of exclusion criteria. Vizier identifies patients who appear on the exception register but whose clinical record does not support the exception reason, allowing you to re-include them and recover the points.
Achievement Threshold Optimization
QOF uses a sliding scale payment model: achievement below the minimum threshold (typically 45–55%) earns nothing; achievement above the maximum threshold earns full points. The highest marginal return is in the range between the lower and upper thresholds. Vizier calculates your current achievement level, shows you the distance to each threshold, and identifies the minimum number of patient interventions needed to increase your score.
Disease Prevalence and Register Analysis
Underdiagnosis is a financial risk as well as a clinical risk. If your registered prevalence for a condition is significantly below the national average for your population, you may be missing patients on the register — and missing the associated QOF income. Vizier compares your disease register size against local and national prevalence benchmarks to identify potential under-registration.
Recall Management Analytics
QOF annual reviews and recall appointments are the operational engine of QOF achievement. Vizier identifies patients who are due for recall, overdue for recall, or approaching the end of the QOF year without a completed review — sorted by the number of indicator points at risk for each patient.
QOF 2024/25 Domain Breakdown
Cardiovascular Disease
Hypertension (HYP)
84
points
Blood pressure control in the hypertension register. HYP003 (BP ≤ 140/90) is the highest-weighted single cardiovascular indicator. Vizier identifies patients on the register whose last recorded BP was above the threshold.
Atrial Fibrillation (AF)
27
points
Anticoagulation and risk assessment in the AF register. CHADS2 and CHA2DS2-VASc score completeness, anticoagulant prescribing rates.
Heart Failure (HF)
55
points
ACE inhibitor/ARB prescribing, LVEF measurement, specialist referral documentation, and annual review completion.
Stroke and TIA (STIA)
26
points
Anticoagulant prescribing in stroke/AF patients, blood pressure control, lifestyle advice documentation.
Peripheral Arterial Disease (PAD)
11
points
Antiplatelet prescribing rates and cholesterol management in the PAD register.
Coronary Heart Disease (CHD)
41
points
Antiplatelet prescribing, cholesterol management, blood pressure control, and annual review completion in CHD register patients.
Diabetes
Diabetes Mellitus (DM)
169
points
The largest single domain in QOF. Key indicators include HbA1c control (DM020, DM021: ≤58 and ≤75 mmol/mol), blood pressure control, cholesterol management, foot examination, retinal screening, urinary ACR, and education provision. Vizier calculates performance on each indicator and identifies patients who need intervention.
Mental Health
LSMI Register and Care Planning (MH)
45
points
Register completeness for severe mental illness, annual care plan review, physical health checks (BP, BMI, cholesterol, blood glucose, smoking status). Physical health monitoring compliance in mental health patients is frequently underperformed.
Dementia (DEM)
19
points
Dementia register completeness, memory assessment service referral, annual review with carer.
Depression (DEP)
22
points
PHQ-9 assessment within 8 weeks of new diagnosis, and follow-up review at 10–35 weeks.
Respiratory
COPD
46
points
Spirometry confirmation, MRC dyspnoea score, inhaler technique review, and annual review completion. Unconfirmed diagnoses on the COPD register are a common exception source.
Asthma (AST)
45
points
Spirometry confirmation, asthma annual review including written action plan, smoking status and cessation, and risk stratification for exacerbation.
Kidney Disease
CKD (CKD)
35
points
CKD register completeness, blood pressure control in CKD patients, ACE inhibitor/ARB use in CKD with proteinuria, and urinary ACR testing.
How many QOF points are you leaving behind?
Upload your SystmOne or EMIS export. Vizier calculates your current achievement and identifies every recoverable point.