Appointments in General Practice: Frequently Asked Questions

Information is included from participating EMIS, TPP, Cegedim and Babylon (GP at Hand) practices. Practices must have agreed to participate in the collection in order for NHS Digital to receive their data. Practices using other system suppliers will not have their data included in the collection and those using a combination of suppliers to manage their appointment book may also have only partial data included.

Data for some practices has also been removed from the publication. Practices with the following criteria have been excluded:

• inactive and closed practices
• practices with an appointment rate of less than 1 appointment per registered patient per year

General practice activity provided via PCNs on behalf of practices is not yet collected and therefore these appointments will not be included in this data. Similarly enhanced access activity may also not be included unless it is recorded directly in a practice’s main appointments system.

Coverage information is included in Table 1 of the Appointments in General Practice Summary tables.

Data in the General Practice Appointments Data (GPAD) collection is known to contain a number of data quality issues. This is due to variation in working methods and recording between different practices. Practices manage their appointment books in the way they best feel allows them to manage the health and care of their patients and not for the purpose of data analysis and there is a widespread variation in approach to appointment management between practices.

A number of other factors must also be taken when interpreting practice level data including:

• The demographics of the patients registered at the practice. For example, practices are likely to have differing age profiles of patients which in turn will impact on the demand and nature of appointments required.
• The level of deprivation in the local area served by the practice and the impact of this on the prevalence of long term illnesses.
• The number of care homes the practice offers services to.
• The use of list and untimed appointments. These appointments are included in the GP system and serve as lists of activities that need to happen at any point in the day and often include telephone triage lists and home visits. These may appear in the appointment book as one appointment whereas other practices may record these as individual appointments throughout the day.

Each of the individual measures (e.g. appointment mode, health care professional type, national category) within the publication have specific data quality considerations. For further information on these please see the supporting information webpage here: Appointments in general practice: supporting information - NHS Digital

Practices and PCN's are able to view their own data on the GP Appointments Data Dashboard in order to identify potential data quality issues within the data that NHS Digital holds for their practice/PCN. For more information on the dashboard and how to access it click here.

If practices require support or advice regarding ways to improve data quality please email [email protected]

Data is collected each week from practices via their GP system supplier. The data extracted is a snapshot of the appointment book at that specific time. Not all GP activity, consultations or encounters are presented in this publication as only appointment slots captured in the practice system are collected.

NHS Digital then process this data and remove any appointments that have an ‘available’ status. These may include:

• unused patient facing appointments
• untimed appointments
• administrative tasks
• training
• breaks
• appointments which were cancelled by patients at short notice and not rebooked to another patient
• any appointment or activity not recorded in the practice appointment system

No clinical or patient identifiable data is collected through this extract. There is no information on what the appointment was for, any notes made by the clinician or any details about the patient extracted.

Actual duration is recorded differently depending on the practice’s system supplier. Currently around 25% of attended appointments have an unknown actual duration or are flagged as having a data quality issue therefore releasing this data at practice level may be misleading.

NHS Digital are working with GP system suppliers and practices to address this issue with the aim to releasing actual duration at practice level in the future.

There is an issue with some TPP appointments where NHS Digital do not receive any slot type information which includes the national category. This is due to how receive the data extracts are received from TPP. The issue relates to squeeze in appointments. The result of this means that even though a practice has mapped 100% of their slot types in their appointment book, they may see that their appointment count in mapped terms is less than 100%, as those appointments cannot be attributed to a national category. These appointments are still included in the overall counts. This has been raised with TPP and NHS Digital are looking into a solution for this matter.

NHS Digital regularly ask for feedback from users of its publications to help further development. A feedback form is available here or please email [email protected]