Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the potential impact of transport, housing instability, language barriers and digital exclusion on patient engagement with QOF requirements in high-deprivation areas.

In the 2024 to 2025 contract year, 83.2% of practices achieved over 90% of the available Quality and Outcomes Framework (QOF) points. General practices (GPs) servicing populations in areas of higher deprivation face greater levels of unmet need and barriers to patient engagement, which can affect delivery against contractual frameworks, such as QOF.

The indicators and thresholds included in the QOF are developed in accordance with National Institute for Health and Care Excellence guidelines and are underpinned by a robust evidence base. Thresholds are designed to be attainable, reflecting the potential challenges involved with delivering the intended outcomes for certain interventions or care practices, while encouraging and incentivising practices to provide the best possible care. Thresholds are aspirational rather than a contractual obligation.

We recognise the importance of ensuring funding for core services is distributed equitably between practices across the country. This is why we are currently reviewing the way GP funding is allocated across England (the Carr-Hill formula). The review will look at how health needs are reflected in the distribution of funding through the GP Contract.

To ensure that patients are not digitally excluded, the GP Contract is clear that patients should always have the option of telephoning or visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a GP. Practice receptions should be open so that patients without access to telephone or online services are in no way disadvantaged.

In 2025, NHS England published an improvement framework for community language, translation, and interpreting services to support the provision of consistent, high-quality community language translation and interpreting services by the National Health Service to people with limited English proficiency. In primary care, the framework supplements the existing guidance for commissioners on interpreting and translation services.

NHS England’s statement on information on health inequalities sets out details on the recording of housing status. This can enable a better understanding of how social risk factors such as insecure housing or homelessness affects health outcomes and health inequalities. The statement is available at the following link:

https://www.england.nhs.uk/publication/nhs-englands-statement-on-information-on-health-inequalities/