The Quality and Outcomes Framework (QOF) was introduced in 2004 to address these problems (Cashin et al., In 2011/12 there were a maximum of 1 000 points available to practices for meeting set targets, their attribution weighted for different indicators, with practices paid an average of GBP 130.51 per point. Although uptake of the QOF contracts is voluntary for general practices, virtually all practices in England are represented by QOF contracts.