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Financially incentivising quality improvement (QI) activity is a novel approach that was introduced into the English general practice Quality and Outcomes Framework (QOF) in 2019. It was not fully implemented until 2022/3 because QOF income was protected during the COVID-19 pandemic. The key novelty is that practices receive financial reward for carrying out quality improvement activities, rather than for delivering specific processes of care or clinical outcomes.

In practice, quality improvement in the QOF means that practices are financially incentivised for carrying out Plan-Do-Study-Act cycles according to guidance on topics set by NHS England. There is no requirement for general practices to demonstrate that any improvement activity led to a change in clinical practice or outcome to receive the reward.