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

·      Retirement of income-protected indicators, affecting potential earnings (some of QOF funding moving into Global Sum so calculated in a different way).

·      Shifts in point allocations, particularly in CVD prevention and chronic disease management.

·      Threshold changes, requiring practices to achieve higher performance targets for full payment.

Action Points:

·      Review which indicators have been removed and how income will be affected.

·      Adjust clinical priorities to align with high-value QOF areas.

·      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

·      Review Annex B of the GP contract to see which indicators have been removed.

·      Calculate how much of your 2024/25 QOF income was dependent on these indicators.

·      Develop a strategy to recover lost income by improving performance in remaining areas.

Checklist:

·      Identify retired indicators and their financial impact on your practice.

·      Shift focus to remaining high-value indicators to compensate for income loss.

·      Ensure exception reporting is correctly applied to minimise financial shortfalls.

Optimise Performance in High-Priority QOF Areas

·      CVD prevention is now a primary focus – ensure statin prescribing and lipid monitoring are optimised.

·      Chronic disease management indicators (e.g. diabetes, hypertension, asthma) now carry more weight.

·      Regularly monitor achievement rates and identify underperforming areas.

Checklist:

·      Maximise performance in indicators with higher point values.

·      Run monthly QOF reports to track progress against targets.

·      Use automated recalls and alerts to capture eligible patients.

Adjust for New Performance Thresholds

·      Some indicators now require higher achievement levels for full payment.

·      Identify where thresholds have been raised and prioritise clinical interventions accordingly.

·      Ensure coding accuracy to avoid missing out on QOF points.

Checklist:

·      Review 2025/26 QOF thresholds and compare them with last year’s performance.

·      Identify gaps where additional work is required to meet new targets.

·      Ensure accurate recording and coding of all QOF-related activity.

Strengthen Financial Planning & Forecasting

·      Model different financial scenarios based on anticipated QOF performance.

·      Ensure staff are aware of income risks and opportunities related to QOF changes.

·      Regularly engage with PCNs and ICBs to discuss QOF financial performance.

Checklist:

·      Conduct financial impact assessments for different achievement levels.

·      Implement monthly QOF financial tracking.

·      Adjust practice workflows to prioritise high-value QOF areas.

Next Steps & Deadlines

🗓 April 2025 – New QOF indicators and thresholds come into effect.

🗓 Ongoing – Monitor financial performance and adjust strategies accordingly.

Immediate Actions:

·      Review retired indicators and adjust practice focus.

·      Ensure performance tracking is aligned with new thresholds.

·      Develop financial forecasts based on updated QOF payments.

📢 Stay updated with PCIT communications to maximise QOF income!