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. 

QOF income in any financial year is calculated using 3 variables:

  • QOF points achieved - The value of a QOF point for 2021/22 is £201.16.
  • Contractor Population Index (CPI) - this is your practice list size divided by the "national average list-size", which changes annually (for 2021/22 it is 9,085 patients)

For example if your list size is 16,000 patients then your CPI is 16,000 / 9,085 = 1.76.

  • Adjusted Practice Disease Factor (APDF) - this is your practice disease prevalence for a particular chronic disease divided by the national average disease prevalence. You can view your practice prevalence data from last year using NHS Digital's online database (although we find easier to use).

For example the national average prevalence of AF for 2020/21 is 2.03%. If your practice prevalence is 3.05% then your APDF for AF will be 3.05/2.03 = 1.50.

All 3 of the above variables influence what payment is made for each QOF domain:

QOF payment = Points Achieved x £201.16 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 £201.16 x 1.76 x 1.50 = £15,400

Please note that no one has access to 2021/22 prevalence data as it is not extracted until March 31st 2022. The above calculations will therefore only be approximate as we have to use 2020/21 national prevalence data.


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 Prevalence0.7% (available on
CPI            1.10 (10000/9085)
QOF point value£167.54 (£201.16 x 1.10 x (0.53/0.7)
Max Domain value (44 points)£7,371.65

But, if the register were increased to 72:


Practice list size  10000
Dementia – current register  72
Practice prevalence 0.72% (70/10000)
National Prevalence 0.7
CPI            1.10 (10000/9085)
QOF point value£227.60 (£201.16 x 1.10 x (0.72/0.7)
Max Domain value (44 points)£10,014.32

Or, to look at it in a different way, each Dementia patient is worth around £139.

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: