This support article attempts to explain the calculations behind your QOF income. It is something which will perplex primary care forever, but see below our understanding. 

As you know, a QOF point value varies according to practice size and uses 3 figures in its calculation:


    • Basic value per QOF point (£194.83 for 2020/21)
    • Contractor population index (CPI) which is practice list size divided by national average list size – (8799 in 2020/21) 
    • Adjusted Practice Disease Factor (ADPF) –– adjusts payment according to whether practice prevalence is below or above national average by following formula for each disease area:


Thus a QOF point for each domain is worth £194.83 x CPI x ADPF


Which means that the average practice, with average list size (8799) and average prevalence for a QOF area, would receive £194.83 per point.


So, looking at the effect this has on domains:


Dementia – a practice has 53 patients on the register currently:



Practice list size   10000
Dementia – current register  53
Practice prevalence0.53% (53/10000)
National Prevalence0.78% (available on
CPI            1.14 (10000/8799)
QOF point value£150.45 (£194.83 x 1.14 x (0.53/0.78)
Max Domain value (44 points)£6,619.98

But, if the register were increased to 72:


Practice list size  10000
Dementia – current register  72
Practice prevalence 0.72% (70/10000)
National Prevalence 0.78
CPI            1.14 (10000/8799)
QOF point value£204.39 (£194.83 x 1.14 x (0.72/0.78)
Max Domain value (44 points)£8993.18

Or, to look at it in a different way, each Dementia patient is worth around £125.

Thus prevalence is very important. In fact, increasing your prevalence can be worthwhile even if it means a corresponding reduction in achievement of QOF points.

If you require any further assistance on the process above, please contact Ardens support on: