We often get asked how disease register prevalence and list size affects the value of QOF.
This article explains how QOF is calculated using your practice prevalence data from NHS Digital's online database or www.gpcontract.co.uk.
Note: no one has access to the current financial year prevalence data as it is not extracted until 31st March each year, therefore the calculation examples below will only be an approximate based on the previous financial year’s national prevalence data.
QOF income in any financial year is calculated using 3 variables:
- QOF points achieved - The value of a QOF point for 2022/23 is £207.56
- Contractor Population Index (CPI) - this is your practice list size divided by the "national average list-size", which changes annually (for 2022/23 it is 9,374 patients). For example if your list size is 16,000 patients then your CPI is 16,000 / 9,374 = 1.71.
- Adjusted Practice Disease Factor (APDF) - this is your practice disease prevalence for a particular chronic disease divided by the national average disease prevalence. For example the national average prevalence of AF for 2022/23 is 2.1%. If your practice prevalence is 3.05% then your APDF for AF will be 3.05/2.1 = 1.45.
All 3 of the above variables influence what payment is made for each QOF domain:
QOF payment = Points Achieved x £207.56 x CPI x APDF
So, using the above AF example in a 16,000 patient practice with all 29 points achieved:
QOF payment for AF = 29 x £207.56 x 1.71 x 1.45 = £14,924.71
The full article is available on the Arden’s website and contains additional information and the location of 'case finder' searches that can help increase the Practice's prevalence.