Under Review — this page was due to be reviewed by Friday, 31 May 2024. The information shown here may be outdated.

See below for the 2024-25 versions of the Directed Enhanced Service (DES), Quality and Outcomes Framework (QOF) and Investment and Impact Fund (IIF) documents.


The 2024-25 DES specification shows how practices can participate in the DES, as well as which areas are a focus. Information on improving health outcomes can be found on page 42, as well as a summarized CAN-02 metric on page 120 and 121.


The IIF document forms part of the Network Contract DES. It supports primary care networks to deliver high quality care to their population, as well as supporting the delivery of the NHS Long Term Plan. This document should be read with the DES to encompass all aspects of DES and IIF this year. Relevant cancer sections can be found on page 14.

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Network Contract DES IIF guidance 2023-24 (NHS England)


The QOF guidance document provides additional guidance on the interpretation and verification of the QOF indicators for 2023-24 in England. Relevant cancer aspects can be found on page 87, and relevant cervical screening aspects can be found on page 124.

Review date: Friday, 31 May 2024