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Primary care team
Primary care services provide the first point of contact in the health and care system for most patients. They act as the 'front door' of the NHS. GP practices provide most primary care in England. Dentists, opticians and community pharmacies are also primary care services.
Our primary care team mainly deals with data from GP practices. We design the technical specifications for data extractions on a range of topics within the General Practice Extraction Service (GPES), analysing the data and disseminating our findings. We also collect data about dentists, opticians and community pharmacies.
We manage the National Health Application and Infrastructure Service (NHAIS). The NHAIS is a suite of software implemented across primary care that collects workforce data, patient registration and demographic data. It also provides:
- a data centre hosting service
- a prescription pricing divisional data service
- a cytology statistics service for breast and cervical screening
- a print management service
When a patient visits a GP practice, information about them and their health and care is recorded on the electronic health record (EHR) systems. The systems use codes to define this patient information, which can be collected, analysed and compared.
The main coding system is SNOMED CT, although some older systems may still use Read Codes. Our General Practice Extraction Service (GPES) collects data from EHR systems. Patient data is collected automatically from the system, unless the patient has opted out of this collection by setting a type 1 opt out.
We collect certain information from GP records, including:
- quality outcomes framework measures – on the management of conditions, public health concerns and preventative services
- dementia diagnoses
- care of patients with learning disabilities
- unplanned admissions to hospital
- diabetic retinopathy screening
- patient online management information - for NHS England, who monitor how well GPs are doing in providing online services to their patients
NHAIS also extracts data at the end of each quarter about GP workforce, to form a census of GPs that are on the General Medical Services (GMS) contract.
GPES collects information for a wide range of purposes, including providing GP payments. It works with our Calculating Quality Reporting Service (CQRS), Data Management Service and GP clinical systems as part of the GP collections service. The CQRS system, run by us, is an approval, reporting and payments calculation system for quality outcome-related achievement in GP practices.
Analyse and interpret
We analyse and interpret data in various ways, including:
- GP Contract Services data is analysed for payment – these are additional services GPs can offer their patients
- Quality and Outcomes Framework is used to distribute over £1.2 billion of payments to GPs, based on achievement of performance measures and size of practice
- dementia diagnosis data is analysed to monitor the national dementia diagnosis rate target and address the problem of under-diagnosis
- Learning Disability Observatory data, the first national primary care data collection of people with learning disabilities, is analysed to help understand inequalities between people with and without a learning disability
- individual GP metrics, commissioned by the Secretary of State, are extracted and linked to other data to enable benchmarking
- diabetic retinopathy screening data is extracted for direct patient care and is used by Public Health England (PHE) to invite people for eye screening appointments
- the Clinical Practice Research Datalink (CPRD) helps researchers analyse primary care data and link data sets to other sources from NHS Digital and beyond.
The primary care team makes sure the data we extract and analyse is reliable and can confidently be used to improve health and care. The clinical expertise of our team is crucial, particularly in making sure the two medical terminologies currently in use, SNOMED and Read codes, are matched appropriately and associated properly with new QOF metrics.
We make analysis of extracted data available to practices and commissioners through CQRS reports. Other aggregate information is available on our primary care web pages.
Ophthalmic and Dentistry activity data and GMS census data is produced for use by NHS England and the Department of Health and Social Care (DHSC) in policy and planning.
We perform an advisory role for Secretary of State, DHSC and NHS England senior colleagues on potential uses of primary care data to inform key policies and the 5-year general practice forward view. We also produce answers to parliamentary questions, freedom of information requests and other ad hoc data requirements.
Patient Online Management Information (POMI) can be found on our website, and in our interactive power BI. Users can see how a GP or CCG is performing in providing online services to their patients, and how the country as a whole is performing in providing online services.
We work closely with analysts in NHS England, DHSC, Care Quality Commission and Public Health England, among others, to provide the data needed to monitor policy initiatives to improve care for patients.
The current annual GP Census provides ministers, the DHSC, outside bodies and the wider public with information on GPs, the services they provide and the staff they employ. This information is used to monitor and develop policies in primary care, in GP workforce planning and GP payments. Data from the census is also used to inform negotiations with the British Medical Association and other health associated bodies, for GMS expenditure forecasting and by the Doctors and Dentists Review Body in recommending pay awards.
The data extracted by us directly impacts the payments received by individual GPs and can be a powerful lever to influence their practice.
Researchers can also access primary care data directly from providers and commissioners. The Clinical Practice Research Datalink (CRPD) support has led to over 2,000 publications including, for example, the proof of safety of the MMR vaccination. The Evidence Based Medicine Datalab enables providers and commissioners to more easily identify unwarranted variation. Despite successes and the enormous potential of such research, the data has been underused.
Possible data flows from primary care through to research are summarised here: