Overview

The 2025/26 QOF contract introduces new indicators, retired measures, and adjusted thresholds, all of which will have a direct financial impact on GP practices. Understanding these changes is crucial to maximising QOF income and ensuring practices adapt to the new requirements.

Key Financial Changes in QOF 2025/26

1. Retirement of income-protected indicators, affecting potential earnings (some of QOF funding moving into Global Sum so calculated in a different way).
   
2. Shifts in point allocations, particularly in CVD prevention and chronic disease management.
   
3. Threshold changes, requiring practices to achieve higher performance targets for full payment.
   

Action Points:

1. Review which indicators have been removed and how income will be affected.
2. Adjust clinical priorities to align with high-value QOF areas.
   
3. Ensure performance tracking systems are in place to meet revised thresholds.
   

Step-by-Step Guide to Managing QOF Financial Impact

Assess the Impact of Retired Indicators

1. Review Annex B of the GP contract to see which indicators have been removed.
2. Calculate how much of your 2024/25 QOF income was dependent on these indicators.
   
3. Develop a strategy to recover lost income by improving performance in remaining areas.
   

Checklist:

1. Identify retired indicators and their financial impact on your practice.
   
2. Shift focus to remaining high-value indicators to compensate for income loss.
   
3. Ensure exception reporting is correctly applied to minimise financial shortfalls.
   

Optimise Performance in High-Priority QOF Areas

1. CVD prevention is now a primary focus – ensure statin prescribing and lipid monitoring are optimised.
   
2. Chronic disease management indicators (e.g. diabetes, hypertension, asthma) now carry more weight.
   
3. Regularly monitor achievement rates and identify underperforming areas.
   

Checklist:

1. Maximise performance in indicators with higher point values.
   
2. Run monthly QOF reports to track progress against targets.
   
3. Use automated recalls and alerts to capture eligible patients.
   

Adjust for New Performance Thresholds

1. Some indicators now require higher achievement levels for full payment.
   
2. Identify where thresholds have been raised and prioritise clinical interventions accordingly.
   
3. Ensure coding accuracy to avoid missing out on QOF points.
   

Checklist:

1. Review 2025/26 QOF thresholds and compare them with last year’s performance.
   
2. Identify gaps where additional work is required to meet new targets.
   
3. Ensure accurate recording and coding of all QOF-related activity.
   

Strengthen Financial Planning & Forecasting

1. Model different financial scenarios based on anticipated QOF performance.
   
2. Ensure staff are aware of income risks and opportunities related to QOF changes.
   
3. Regularly engage with PCNs and ICBs to discuss QOF financial performance.
   

Checklist:

1. Conduct financial impact assessments for different achievement levels.
   
2. Implement monthly QOF financial tracking.
   
3. Adjust practice workflows to prioritise high-value QOF areas.
   

Next Steps & Deadlines

1. April 2025 – New QOF indicators and thresholds come into effect.
   
2. Ongoing – Monitor financial performance and adjust strategies accordingly.
   

Immediate Actions:

1. Review retired indicators and adjust practice focus.
   
2. Ensure performance tracking is aligned with new thresholds.
   
3. Develop financial forecasts based on updated QOF payments.
   

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