Quality and Outcomes Framework (QOF) and primary care business rules

NHS England is responsible for producing and maintaining the extraction specification (business rules) for Quality and Outcomes Framework (QOF), Enhanced Services (ES), Vaccinations and Immunisations V&I, certain elements of Core Contact (CC) and other services commissioned by the Department of Health and Social Care.

Cardiovascular Disease Prevention Audit (CVDPREVENT)

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Cardiovascular Disease Prevention Audit (CVDPREVENT)

CVDPREVENT is a national primary care audit that will automatically extract routinely held GP data, via GPES. It will provide a foundation for professionally led quality improvement in individual GP practices across Primary Care Networks (PCNs).

Coronavirus (COVID-19)

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Coronavirus (COVID-19)

These patient level data collections are in response to the intense demand for general practice data to be shared in support of vital pandemic planning and research for COVID-19 purposes.

Enhanced Services (ES), Vaccinations and Immunisations (V&I) and Core Contract (CC) components business rules

NHS England have released the business rules for the enhanced services (ES), Vaccinations and immunisations (V&I) and Core Contract components (CC). This page will be updated as further ES, V&I and CC business rules become available.

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Enhanced Services (ES), Vaccinations and Immunisations (V&I) and Core Contract (CC) components business rules

General practice to diabetic retinopathy screening (GP2DRS)

Evidence shows that early identification and treatment of diabetic eye disease could reduce sight loss. The main treatment for diabetic retinopathy is laser surgery. This service looks to identify those at risk of developing diabetic retinopathy.

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GP2DRS (Diabetic eye screening programme)

Screening is the process of identifying people who appear healthy, but who may be at increased risk of a disease or condition.

Indicators no longer in QOF (INLIQ)

As part of the contractual agreement it was agreed to continue collecting information relating to indicators no longer in QOF (INLIQ). Indicators retired since 2014-2015 will continue to be collected under this extraction. The reporting is essential, as the Department of Health and Social Care, Public Health England and other healthcare groups have indicated that the information linked to these indicators is essential for their work and wider healthcare programmes.

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Indicators no longer in QOF (INLIQ) business rules

Individual GP level data

The Government's mandate to NHS England includes a task of working with NHS Digital and The Department of Health (DH) to provide GPs and general practices with information on the care provision for their patients.

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Individual GP level data

The Department of Health and Social Care has directed NHS England to collect clinical data for a given set of metrics at individual GP level and report these data back to GPs and general practices only. GPs and general practices will receive non-identifiable data for their own patients; they will not receive any identifiable data or data for patients from other general practices.

Learning Disability, Autism and ADHD Data Set

The Learning Disability Autism and ADHD Data Set is a new patient-level extract for people in England with a learning disability, autism or ADHD. It replaces the existing Learning Disability Data aggregate data collection.

This new patient-level extract has been created because:

these groups face health inequalities, high rates of avoidable mortality and poor access to tailored services
the NHS is legally and strategically committed to reducing inequalities (10 Year Plan, Equality Act, NHS Act)
the current Health and Care of People with Learning Disabilities (HCPLD) data extract is aggregate, limited to 55% of patients and lacks granularity for in-depth analysis.

This data set replaces the HCPLD.

The data set aims to:

provide approximately 97% patient coverage
enable linkage to other health data sets for insights into prevalence, access, outcomes and prescribing
support commissioning with clear prevalence data
improve monitoring of health checks, screening and medication reviews
identify unmet needs, reduce admissions and support prevention
offer the ability to track ADHD/autism diagnosis, co-occurring conditions and prescribing
enable benchmarking to improve services and reduce inequalities

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Learning Disability, Autism and ADHD Data Set

Learn why the Learning Disability, Autism and ADHD Data Set was developed and download the business rules for 2026.

Learning Disabilities Data (LDD)

The LDD aims to:

make information about the health and healthcare for people with learning disabilities more readily available and understandable
undertake detailed secondary analyses of existing datasets to identify important new lessons for service improvement and development
share the learning by working to ensure that key messages about best practice in providing healthcare for people with learning disabilities are widely understood
improve available information by surveying data gaps and working to fill them.

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Learning Disabilities Data (LDD)

The learning disabilities data collection supports the production of a range of primary care indicators to get a more detailed understanding of the health of people with learning disabilities in each part of the country.

Lipid management

In May 2025, support for this service was stopped. An expanded cluster list as at 19 May 2025 has been included in the Lipid management business rules and expanded cluster list download for reference.

The content of code clusters that are used in other General Practice Extraction Service (GPES) rulesets will continue to be managed, but where code clusters are not used in any other services, they will be retired and their content will no longer be actively managed

The ruleset lays out how general practice systems should search for specific clinical information in patient records. Firstly, the searches look for patients who already have cardiovascular disease and then filter out those whose lipid control is good; they then find those who have had difficulties with or have not wanted lipid lowering therapy in the past so that clinicians can consider what next steps to take, including offering one of the newer therapies.

For the remaining patients, the searches then determine which of the available treatment options (several high intensity stain and other non-statin alternatives) may be suitable, taking into account relevant factors such as allergies, current lipid levels and kidney function. The end result is a list of patients for each group of possible treatment options which can be used by practices to review patient records and then call patients for review.

There are 2 sets of business rules included in the zip file below. The difference is in the way they are structured, with the new style ones reducing some of the duplication of logic needed by the usual style business rules. System suppliers have the choice of using whichever business rules suit their set up.

Unlike with other business rules, data relating to this service is not collected by NHS England.

Lipid management business rules and expanded cluster list

zip 997 KB

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Lipid management searches

We've developed a new lipid management search tool to cover atherosclerotic cardiovascular disease (ASCVD) and the secondary prevention lipid management pathway, which will help those in general practice to proactively identify patients who may benefit from treatment intervention or review.

NHS Health Checks

NHS Digital, acting on behalf of Public Health England (PHE), will be collecting information about the numbers of people who are invited to an NHS Health Check and either attend or do not attend.

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NHS Health Checks

NHS Digital, acting on behalf of Public Health England (PHE), will be collecting information about the numbers of people who are invited to an NHS Health Check and either attend or do not attend.

Physical health checks for people with severe mental illness (PHSMI)

PHSMI data extract collects information detailed on GP records for patients with severe mental illness and not recorded as ‘in remission’.

This collection helps to ensure that people with severe mental illness have their physical health needs met by monitoring the delivery of comprehensive physical health check, collects information on relevant follow-up interventions and to understand their physical health outcomes.

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Physical health checks for people with severe mental illness (PHSMI)

This collection will help to ensure that people with severe mental illness have their physical health needs met by monitoring the delivery of a comprehensive physical health check. It will provide information on relevant follow-up interventions and help to understand physical health outcomes.

Primary Care Domain Reference Set Portal

The Reference Set Portal is an interactive tool which allows users to see which SNOMED codes are included in the current version of a reference set (refset)/cluster as used by the business rules.

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Primary Care Domain Reference Set Portal

The clusters of codes used within business rules, produced by the Primary Care Domain, are now displayed using reference set identifiers (refset IDs).