GP staff survey summary report - General Practice Data for Planning and Research (GPDPR)

This research sought to gather the opinions of general practice staff across England on GPDPR and associated topics, such as opting out and burden reduction.

It was intended to provide us with a sense of the current levels of knowledge of GP staff on a range of issues related to the patient data they collect, as well as telling us which areas we might need to understand further in order to develop clear and useful messages, communication assets and training materials for this audience.

The Royal College of GPs (RCGP) and the British Medical Association (BMA) helped us to set the questions and to promote the survey with their members and we would like to thank them for their support. The survey has provided us with valuable insight.

We found that there is broad support for the programme in principle (49% agreed or strongly agreed with the aims of the programme and only 19% disagreed or strongly disagreed), but those working in GP practices have varying degrees of confidence in explaining different elements of the programme to patients. The majority of respondents (66%) are confident in explaining opt outs and why patients sharing their data is important for research and planning, but confidence drops when discussing more technical topics linked to data use and data sharing.

This survey tells us that approving data extract requests and reactively responding to patient enquiries creates additional burden for GP practices and respondents would like us to explore ways of reducing that burden. There is a need for information about data and data sharing to be more easily digestible and clearer, both for staff and patients.

This survey uncovered that a third of those surveyed in GP practices don’t know what a type 1 data opt out is, with 56% of GPs saying that they do not know what a type 1 opt out is. 82% of respondents did not feel they had enough information about GPDPR, which provides the programme with a huge opportunity to fix this problem. This issue is replicated in the general population and other research has shown that patients and the public are also confused by the current data opt out landscape. 

In March 2022 we launched a pilot online survey across 9 integrated care systems. The purpose of the survey was to listen to general practice staff on key areas ahead of wider, national engagement. We used this opportunity to refine the question set and design of the survey before launching a much broader survey with general practice staff.

In May 2022 we launched a national online survey with general practice staff engaging with staff on GPDPR, burden reduction and health data use more broadly. We developed this survey in partnership with the BMA and RCGP. The survey was cascaded via NHS Digital, the BMA, RCGP and NHS England. 

The objectives of this research were to

• set a baseline for knowledge and attitudes towards GPDPR and opt outs
• understand burden experienced by general practice staff associated with managing patient data and how it can be reduced

In total, 472 people engaged with the survey. 86 respondents stated they don’t work within an NHS GP surgery and were therefore screened out. 386 people working in general practice took part in the survey between 20 May and 14 June 2022. 218 people completed the survey fully.

We heard from a mixture of professional groups working in GP practices, with the majority either being practice managers (or equivalent) or GPs.

We appreciate the data may be more skewed towards these groups in the analysis as people within these roles are more likely to be signed up to receive bulletins compared to other roles, such as administrative staff and other clinicians.

Furthermore, the data in this survey isn’t representative of the whole general practice workforce, but we are using this as an indicator of what to explore further as part of the Engagement phase.

Local vs national influence

One of the key themes that we’ve found indicates a perceived difference in who should have a say on how data collected by practices is used. When asked who should have a say in deciding how data for direct care is used, 85% believe GP practices should, compared to 51% that think national NHS organisations should. When asked about who should have a say in deciding how data for planning and research is used, 66% believe that national NHS organisations should compared to 46% who think general practice should have a say.

Respondents reported being more confident about patient data being managed at a local and regional level, with higher confidence being attributed to general practice followed by clinical commissioning groups (CCGs) or integrated care systems (ICSs).

We need to support staff in how they talk to patients

Staff are generally confident in explaining broad areas linked to patient data, such as patient choice (66%) and why patients sharing their data is important for research and planning (66%). However, confidence drops for more specific and technical areas, such as where data is stored (43%), risks associated with de-identified data (45%) and explaining what could go wrong with sharing their data (46%). This provides us with a vital insight into which areas we should explore further with GPs and general practice staff.

Perceived burden associated with managing patient data isn’t centred around processing opt outs

We asked respondents what their biggest burden was associated with managing patient data. The highest areas of burden were approving requests for data extracts and reactively responding to enquiries. Some respondents experienced burden associated with processing opt outs and proactive engagement with patients, though this wasn’t as prevalent. 

When we asked respondents what they thought would help reduce burden, 4 key themes appeared.

Patient control

Respondents want patients to have the ability to implement their opt out choices. Some have suggested this could be done through the NHS App. 

Simplify communication

Messages, including requests to general practice, are not clear. Respondents mentioned they are overwhelmed by complying with data sharing agreements and technical detail. Furthermore, patient-facing communication should be easy to understand and clearly state opt out options.

Centralise data collection

Some have suggested having a centralised data collection process will reduce burden from GPs, with some suggesting removing them from being data controllers could also help.

Education need

Patients and practice staff are unaware off what current information means. It’s difficult to understand, not clear and full of jargon. 

We need to boost knowledge in type 1 opt outs and GPDPR

33% of respondents stated they didn’t know what a type 1 data opt out was, with the majority of this group having never heard of it before. GPs are most likely not to know what a type 1 data opt out is (56%), compared to practice managers where only 9% of those surveyed said they didn’t know what a type 1 data opt out was.

30% of respondents haven’t seen, heard or read anything about GPDPR and a further 5% didn’t know if they had. When breaking this down by job role, there aren’t wide gaps in the same way that we’ve observed in knowledge of type 1 data opt outs. 32% of practice managers didn’t know about GPDPR, in comparison to 26% of GPs. 

In principle, respondents are supportive of the aims of the programme (49%) but aren’t confident in explaining the programme to their patients (24%). Furthermore, less than a fifth (18%) felt they have received sufficient information about the programme.

The findings from this research have provided us with vital insights into how we can address issues with practice staff as part of the engagement phase, particularly around what areas staff might need support on to better understand patient choice and GPDPR. 

As we move into the engagement phase of the communications and engagement workstream, we will work with GP staff to co-create the materials they need to fill the knowledge gap that we have discovered and to openly identify and discuss concerns and benefits of the work. We will do this by using the insight gathered so far to facilitate qualitative research with GP staff across various roles, helping to build a picture of how staff interact with patients on data, GP staff communication needs and developing messaging and materials that help reduce burden associated with managing patient data.