But the statement of fees and allowances on the DoH website explicitly states that Q&O is optional. -----Original Message----- From: Fay Wilson [mailto:[log in to unmask]] Too late to say Yuck now. 79% voted for it, no good coming over all nice at this stage. And don't think you can get all high minded and opt out of Q&O and forgo the money. A Top Person from the NHS Confederation negotiating team has publicly said that practices with low Q&O scores will be reported to the NCAA.