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QOF Implementation: Business Rules

PCTs should contact their PCC contracting advisors if any further explanation of the business rules is required. GPs and practice managers should refer to their PCT.

The Q&A section provides quality-assured answers to many primary care contracting questions. Individuals are requested to consult this prior to raising a query.

The rules are in two versions, one for each indicator set depending on whether the GP system uses version 0 or version 2 Read codes. 


QOF business rules v 16.0 - updated December 2009

Please note there is only one version of the rule-sets.  Rule-sets for 4 byte systems have not been published.

Dataset and Business Rules summary guide which is designed to help individuals working with the QOF rulesets establish the changes from version 15.0 to version 16.0.

Download rulesets v 16 in one compressed (ZIP) folder.

5 Byte, CTv3 and SNOMED
 Asthma
 Atrial fibrillation
 Cancer
 CHD
 CKD
 COPD
 CVD PP
 Cytology
 Dementia
 Depression
 Diabetes
 Epilepsy
 Heart failure
 Hypertension
 Learning disabilities
 Mental health
 Obesity
 Palliative care
 Records
 Sexual health
 Smoking
 Stroke
 Thyroid

QOF business rules v 15.0 - updated September 2009

Please note there is only one version of the rule-sets.  Rule-sets for 4 byte systems have not been published.

Changes to QOF business rule-sets are outlined in this Excel spreadsheet. 

Download rulesets v 15.0 in one compressed (ZIP) folder

4 byte is available on request.

5 Byte, CTv3 and SNOMED
 Asthma
 Atrial fibrillation
 Cancer
 CHD
 CKD
 COPD
 CVD PP
 Cytology
 Dementia
 Depression
 Diabetes
 Epilepsy
 Heart failure
 Hypertension
 Learning disabilities
 Mental health
 Obesity
 Palliative care
 Records
 Sexual health
 Smoking
 Stroke
 Thyroid

 

QOF business rules v14 - updated 17 June 2009

Minor change to Sexual Health, Indicator 3, Rule 1. This rule-set now appears as version 14.1.

Donwload Read code v0 in one compressed (ZIP) folder

Download Read code v2, CTV3, SNOMED-CT in one compressed (ZIP) folder

Read code v0

 Read code v2, CTV3,   SNOMED - CT
 Asthma  Asthma
 Atrial fibrillation  Atrial fibrillation
 Cancer  Cancer
 CHD  CHD
 CKD  CKD
 COPD  COPD
 Cardio vascular  Cardio vascular
 Cytology  Cytology
 Dementia  Dementia
 Depression  Depression
 Diabetes  Diabetes
 Epilepsy  Epilepsy
 Heart failure  Heart failure
 Hypertension  Hypertension
 Learning disabilities  Learning disabilities
 Mental health  Mental health
 Obesity  Obesity
 Palliative care  Palliative care
 Records  Records
 Sexual health Sexual health
 Smoking  Smoking
 Stroke  Stroke
 Thyroid  Thyroid