Since April 2004 General Practice was given the option to carry out additional work for additional money. The framework for this additional work has so far been agreed and is reviewed by the Department of Health and the General Practitioners Committee. There are various components covering clinical, organisational and patient experience aspects. Participation in the QOF is voluntary, but practices not taking part and not carrying out this extra work are already being branded as "bad quality providers". In our eyes the framework has very little to do with QUALITY. It is mainly a tool to satisfy managers enthusiasm for ridiculous policies and procedures, which prevent the smooth operation of General Practice and the provision of high quality individually tailored patient care. In General Practice the framework is widely known as the Bean-Counting-Framework.

Nevertheless, Highgrove Surgery does take part and has achieved high quality scores since its introduction.

• 2004-05   977 points out of a maximum of 1050
• 2005-06   1000 points out of a maximum of 1050
• 2006-07   991 points out of a maximum of 1000
• 2007-08   998.38  points out of a maximum of 1000
• 2008-09   988.23 points out of a maximum of 1000
• 2009-10   982.58 points out of a maximum of 1000
• 2010-11   984.70 points out of a maximum of 1000
• 2011-12   998.21 points out of a maximum of 1000
• 2012-13   992.06 points out of a maximum of 1000
• 2013-14   887.58 points out of a maximum of 900
• 2014-15  550.41 points out of a maximum of 559
• 2015-16   555.11 points out of a maximum of 559 (preliminary - not yet verified by NHS England)

The framework changes periodically. You can download a copy of the Indicators General Practice has to achieve here.

All patients who have a chronic disease like asthma, heart disease or diabetes will be invited for annual or bi-annual review appointments. In the context of this we require patient co-operation in attending for these reviews, as this is the most appropriate way of monitoring the condition, collecting data and discuss concerns or other issues that may be relevant to the patient suffering from a chronic illness.