Quality and Outcomes Framework

QOF thresholds for the full SMI physical health check were set at 60–75% of eligible patients for 2024–25, yet NHS England planning guidance made no explicit reference to SMI physical health check targets. Participants drew a clear distinction between measuring health parameters (e.g., recording blood glucose) and actually intervening to improve them (e.g., reducing blood glucose). QOF incentivisation of annual physical health checks produced an unintended consequence, concentrating resources on achieving screening volume targets at the expense of holistic care. QOF incentivisation is useful for establishing a screening baseline but inadvertently disincentivises non-targeted preventive and holistic care.