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 prevalence
0.53% (53/10000)
National Prevalence0.78% (available on www.gpcontract.co.uk)
CPI            1.14 (10000/8799)
QOF point value£150.91 (£194.83 x 1.14 x (0.53/0.78)
Max Domain value (44 points)£6,640.41

But, if the register were increased to 70:

 


Practice list size  
10000
Dementia – current register  
70
Practice prevalence
 0.70%
National Prevalence 1.14
CPI            1.14 (10000/8799)
QOF point value£198.71 (£194.83 x 1.14 x (0.7/0.78)
Max Domain value (44 points)£8743.37

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.