When many people think of the new contract they think of the Quality and Outcomes Framework (OOF) as the major source of income. This is not the case. It is in fact the Global Sum. However, the OOF certainly has the potential to generate a considerable amount of additional income, but I have left it to the end of this book as it is not the only source of income and it is easy to overlook the other possible sources. The OOF is, however, the part of the new contract which forms a large proportion of the promised pay rise for GPs or ‘new’/‘additional’ income and so reward for their ‘extra’ work. However, some doctors may argue that these targets are unrealistic and in some situations may not be achievable. Unlike the targets of the old contract, e.g., in relation to cervical cytology, it is possible to achieve a percentage of a target and so part payment through the attainment of quality indicator ‘points’.