We collect information about the general practice workforce directly from practices using a live, online collection tool. The completeness and coverage of the data collection has improved since we first collected wMDS in September 2015, but nonetheless there are still some data quality considerations.
There are some practices where all the provided data for a staff group is of poor quality and has to be removed. We calculate estimates for headcount and full-time equivalence for those practices which did not provide valid and/or complete data for one or more staff groups; this could be due to poor data quality or no submitted data.
To produce estimates for incomplete or missing data, we use the valid data submitted by the other practices during the reporting period, along with information about their registered patient population. Our estimation methodology takes the practice patient populations into account to address potential issues that could arise if the practices providing no data or poor-quality data were not of a typical or average size. We know the registered patient counts for 98-99% of practices and use the average registered patient count of a practice’s Sustainability and Transformation Plan (STP) area where this information is not available.
We produce our estimates as follows:
- For every job role and STP, we calculate a ratio of FTE per registered patient. This uses the total FTE and registered patient count for all the practices that supplied valid data.
- We calculate FTE estimates at CCG-level by taking the STP job role ratio calculated in step (i) and multiplying it by the total registered patient count for all practices in that CCG that did not supply valid data for the applicable staff group.
- We use the same principles to calculate headcount estimates.
- We aggregate the estimates from CCG level to provide higher level figures at national and sub-national levels.
We produce estimates independently for each of the four staff groups (GPs, Nurses, Direct Patient Care and Admin/Non-clinical staff). This means that if a practice submits no data, or invalid data for a single staff group, their submission for the other three staff groups is still treated as valid.
For the Direct Patient Care staff group, using the same estimation methodology is not appropriate for the following reasons.
- Practices are more likely to be operating without Direct Patient Care staff. This is borne out by the fact the percentage of practices who do not record Direct Patient Care staff in NWRS is much higher than the other staff groups
- The introduction of Primary Care Networks means staff may be employed by the PCN instead. Estimating for them in general practice would therefore over-estimate this part of the primary care workforce
- This is the largest staff group in terms of number of job roles with 18, but no practices who submit information about DPC staff have records for every Direct Patient Care job role. The methodology can only estimate for all job roles within a staff group and so it is highly likely that this leads to overall over-estimation of DPC staff
- Estimation testing (see the Methodological Change Notice) showed erratic results for the DPC staff group, with large overestimates
To limit the degree of over-estimation of Direct Patient Care staff, where a practice has provided information about GPs, nurses and admin/non-clinical staff and only the Direct Patient Care staff group is missing, we do not calculate estimates for that practice. This alternative approach is based on an assumption that the majority of practices who provide information about three staff groups but not Direct Patient Care are likely to not employ Direct Patient Care staff.
We are aware that seasonal variation affects General Practice workforce figures, but as our estimation process calculates ratios using valid data for the applicable reporting period, any seasonal variation should be mitigated.
It is important to note that we do not produce wholly estimated records at individual practice level. At general practice level, we only estimate missing FTE where the staff member’s record is otherwise valid and complete and is simply missing contracted or working hours (see Partial Estimates below).
We do not allocate estimated records any age, gender, or country of qualification information; for these data items, any estimated records are reported against ‘Unknown’.
We no longer produce estimates for GPs in training grades as the timely and complete TIS data means this is not required. However, some historical figures do include some fully estimated records for GPs in training and locums:
- Following the introduction of Health Education England’s (HEE) Trainee Information System (TIS) as the data source for GPs in training, we calculated some estimates for missing data for September 2015 to March 2018. This is discussed in further detail in the GPs in Training (formerly referred to as GP registrars) section. These estimates are available only at a national level and regional figures from June 2018 onwards are not comparable with earlier figures.
- Early in 2017 we introduced new guidance relating to recording data about the locum GP workforce and in March 2017 we noticed a large increase in their numbers. Following a consultation with stakeholders, we calculated FTE estimates for the locum GP workforce to account for records that should have been submitted between September 2015 and December 2016. These figures are published at CCG level but are available only at a high level and do not include personal characteristic such as gender or age so caution should be used when considering such breakdowns in earlier reporting periods. There remains a small ‘step change’ between December 2016 and March 2017, but the overall counts of GP FTEs are believed to be consistent and comparable.
- It was not possible to calculate estimated headcount figures for these locum GPs so there is an unavoidable break in the headcount time series between December 2016 and March 2017. Please refer to the Locums section in the Using this publication section.
- Due to data quality issues with the ad-hoc locum data collection in the last quarter of 2020, the ad-hoc locum figures in Annex B of the Excel Bulletin tables include some estimated FTE figures for December 2020. However, it is not possible to calculate headcount estimates for these ad-hoc locum GPs.
When we create estimates in this way, we do not allocate the records any personal characteristics such as age, gender, or country of qualification information; but report these against the ‘Unknown’ category. This means that figures by these personal characteristics are not comparable across time periods.
Partial estimates (estimated FTE)
We calculate estimated FTE figures for otherwise valid staff records where no information about contracted or average working hours has been provided. The estimates are calculated using the national average FTE for the applicable job role. We refer to these figures are ‘partial estimates’ and the scale of these estimates varies by staff group. Annex A in the Excel Bulletin tables shows the percentage of partially estimated figures for each staff group.