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Publication, Part of

General Practice Workforce, 31 December 2021

Official statistics

Methodological Change - re-introduction of fully-estimated records

We have introduced a significant methodological change in this release and revised the entire time series back to September 2015, which means that figures in this release differ from and supersede those previously published. 

In August 2021 (for the June 2021 publication) we revised the entire General Practice workforce time series back to September 2015, making several methodological changes to the way in which the workforce numbers are calculated.  

  • Fully-estimated records (where a practice has not provided any valid data for a staff group) - were removed. Partial estimates (where the practice provides a record for an identifiable individual but does not include information about their contracted or working hours) - were still made and included in outputs.  
  • Ad-hoc locums - were removed from the main tables as the move to monthly data extracts meant the headcount figures would not be comparable with previous quarterly collections and retaining them in the main tables would lead to an unavoidable break in the time series  
  • Zero hours contracts – where working or contracted hours were recorded in the reporting period, staff are now counted in both the FTE and headcount figures, where neither working hours or contracted hours are recorded, staff are not counted in either.  

Following stakeholder feedback regarding the impact removing the estimates may have had on the rate of the change in parts of workforce, NHS Digital committed to reviewing the removal of fully-estimated records. As a result of the findings of this review, estimates have been reinstated using an improved methodology, and the entire time series has been revised to include these estimates.   All other changes introduced in August 2021 remain in place. 

Please refer to the Methodological Review and Changes page of this publication for more information. 

All historical Individual-level CSVs since September 2015 and Practice-level CSVs for selected reporting periods have been reproduced with revised figures and included with this publication.  We plan to reproduce all relevant historical CSVs in summer 2022, to include the revised figures and remapped to represent the regional structure which is due to come into effect on 1 July 2022.

10 February 2022 09:30 AM

NHS Geography Updates

There have been changes to the NHS England and Improvement regional structure since this release. From 1st July 2022, Integrated Care Boards (ICBs) were established as statutory bodies replacing CCGs and STPs. From the General Practice Workforce, 31 July 2022 publication, data is instead aggregated to Sub-ICB Location, and ICB level. These geography updates also involved boundary changes, with some practices moving to different Sub-ICB Locations and ICBs than they would previously have been situated.

In order to have a consistent and comparable time series at regional level, all Individual and Practice-level CSVs were reproduced as part of the 31 July 2022 release, with practices and Sub-ICB Locations remapped to reflect this latest structure. National totals are unaffected by this remapping but some figures at Sub-ICB (previously CCG) and ICB (previously STP) levels may differ to those previously published.

The regional bulletin tables 6a, 6b, 7 and Annex C, and the Practice and Individual-level CSVs presented here reflect the old structure. Therefore, users are encouraged to use the remapped CSV files released with the 31 July 2022 publication for historical regional general practice workforce figures. The time series table Annex C in the 31 July 2022 bulletin file has also been remapped.

1 July 2022 00:00 AM

Glossary and definitions

Absence is a period when a member of staff was not available for normal duties. Absence information includes study periods.

Ad-hoc Locums: the concept of an ad-hoc locum is an artificial construct implemented for data collection and publication purposes. Ad-hoc locums are locum or sessional GPs who typically work briefly at practices – perhaps only a single one-off session – to cover for short-term or unexpected absences. GPs working in these roles do not consider themselves to be “ad-hoc locums” per se, but the nomenclature can help to understand how these sessional GPs interact with practices.

Administrative data source – a public sector data set for which the primary purpose is business or administrative use, rather than as a data set collected specifically for statistical or research purposes. Examples of administrative data include payroll information, personnel records, educational attainment in schools and colleges, or medical information.

Alternative Provider Medical Services (APMS) contracts can be sought by the private, voluntary, and public sectors. These contracts offer greater flexibility in the nature of service provision which is decided in agreement between the provider and the commissioner.

Clinical Commissioning Group (CCG) - These were established as statutory organisations from April 2013 and took over the responsibilities of Primary Care Trusts (PCTs). They are clinically led statutory NHS bodies responsible for the planning and commissioning of health care services for their local area. It is expected that during 2021 CCGs will be replaced with Integrated Care Systems which will have responsibility for larger geographical areas.

Direct Patient Care (DPC) staff include anyone who is directly involved in delivering patient care within general practice but who is not a Nurse or GP. This group includes Dispensers, Health Care Assistants, Phlebotomists, Pharmacists, Physiotherapists, Podiatrists, Therapists and Other.

Electronic Staff Record (ESR) is a payroll database system commissioned by the Department of Health and Social Care that NHS organisations are entitled to use free of charge. The system is currently used by 99% of NHS Trusts and manages the payroll for over one million NHS employees

Full-time equivalent (FTE) is a standardised measure of the workload of an employed person. An FTE of 1.0 means that the hours a person works is equivalent to a full-time worker; an FTE of 0.5 signals that the worker is half-time.
For the purposes of NHS workforce statistics, we define full-time working hours as 37.5 hours per week. Using FTE, we can convert part-time and additional working hours into an equivalent number of full-time staff. We calculate FTE by dividing the total number of weekly hours worked by individuals in a specific staff group by 37.5.

General Medical Services (GMS) is the contract under which most GPs are employed. It is a national agreement between the provider and NHS England and NHS Improvement which sets out the financial arrangements, the services to be provided and support arrangements.

General Practice is an organisation where patients can be registered and held on a list which offers Primary Care medical services from a qualified General Practitioner who can prescribe medicine. Generally, the term General Practice describes what is traditionally thought of as a high street family doctor’s surgery. For the purposes of this publication the term General Practice does not include Prisons, Army Bases, Educational Establishments, Specialist Care Centres including Drug Rehabilitation Centres, urgent treatment centres and minor injury units. Walk-In Centres are also excluded from the scope of this series of Official Statistics, although some may be included for data quality reasons.

A General Practitioner (GP) is a medical practitioner who treats all illnesses and provides preventative care and health education for patients of all ages. All Practitioners include GP Providers, Salaried/Other GPs, GPs in training, Retainers and Locums.

A GP Provider is a practitioner who holds a contract to provide services to patients. These GPs are referred to as GP Partners in these Official Statistics and may also be known as Contractor GPs.

GPs in training / GP Registrar is a fully registered physician who is being trained for general practice under an arrangement approved by the Secretary of State. This category of GPs includes Foundation Training (FT) 1/2 and Speciality Training (ST).

GPs in training - grade ST1/2 are fully qualified and registered doctors who are in their first or second years of Speciality Training and are working at the general practice on a rotation.

GPs in training - grade ST3/4 are fully qualified and registered doctors in final training and are working at the practice on a rotation with a view to becoming a GP.

GPs in training - grade F1/F2 are fully qualified and registered doctors who are in the first two years of foundation training and are working at the practice on a rotation with a view to becoming a GP.

GP Retainers are fully qualified GPs who deliver a maximum of four sessions in general practice per week to retain skills and progress their careers potentially with a view to increasing their working commitment in the future.

Integrated Care System (ICS) –Following on from STPs, Integrated Care Systems take a greater collective responsibility for resources and their local populations’ health. ICSs are partnerships that unite providers and commissioners of NHS services with local authorities and other local partners to collectively plan health and care provision to meet the specific needs of their local populations. The NHS Long Term Plan sets out the aim for every part of England to be covered by an ICS by 2021. More information about these plans is available from

Locum GPs (also known as sessional GPs) are GPs who provide service sessions in general practice on a temporary basis. They may work in the practices for relatively long periods but may also provide cover on a short-term or ad hoc basis. This group includes Locums covering vacancies, sickness, and maternity/paternity absence.

NHS England and NHS Improvement formed in April 2019 and is the combined organisation of NHS England (preferred name for NHS Commissioning Board) and NHS Improvement which is responsible for overseeing secondary care and independent organisations that provide NHS-funded care.

Nurses include all registered and trainee Nurses working within general practice. This group includes Practice Nurses, Advanced Nurse Practitioners, Nurse Specialists, Trainee Nurses and District Nurses.

National Workforce Reporting Service (NWRS) the National Workforce Reporting Service is used by general practices and primary care networks in England to report data on their workforce. We extract information directly from the system and use it to publish official statistics. More information about the NWRS is available from

Personal Medical Services (PMS) contracts were first introduced in 1998. They allow the provider to negotiate a local agreement for the services they will provide and payments they will receive, considering specific local healthcare needs.

Primary Care Network (PCN) – They are groups of practices working together and with other local health and care providers (e.g., hospitals, mental health or community trusts, community pharmacies and charities) within what are considered natural local communities, to provide coordinated care through integrated teams.

Salaried GPs work within partnerships and are generally remunerated by salary.

Single-Handed Practice is a practice which has only one working (Partner/Provider or Salaried) GP, although a GP in training or GP retainer also may work in the practice.

Snapshot statistic - relates to the situation at a specific date, which for these workforce statistics is the last calendar day in the reporting period.

Sustainability and Transformation Plans (STP) – These were established in 2016 as five-year plans to cover all aspects of NHS funding in England. There were initially forty-four geographical areas on which these plans were based covering populations ranging from 300,000 to 2.9 million with an average of 1.2 million.
In some areas STPs have evolved to become Integrated Care Systems.

Vacancy is where the practice has a substantive post which is not currently filled.

Workforce Minimum Data Set (wMDS) – following the reforms set out in the Health and Social Care Act 2012, the Department of Health and Social Care established the Workforce Information Architecture (WIA) work stream to review and improve handling of the workforce data and intelligence. The WIA recommended that a workforce Minimum Data Set be collected from all providers of NHS funded care. More information about the wMDS is available from our website at

Data items collected in the National Workforce Reporting Service

Main practice workforce

Personal information

  • Forename, other names, surname,
  • Date of birth
  • Gender
  • Ethnicity
  • Staff group
  • Job role
  • Organisation
  • National insurance number
  • Professional registration number (for GPs and Nurses)
  • Training number
  • Registered / Special Interest
  • Qualifications


Contract and working hours information

  • Contract type (e.g. permanent, fixed term)
  • Contracted hours per week
  • Average working hours per week
  • Whether they work Extended Hours

  • Whether they work Extended Access Hours

  • Source of Recruitment
  • Date joined
  • Termination (leaving) date
  • Reason for leaving
  • Destination on leaving

Ad-hoc locums

  • Forename, surname
  • Professional registration number
  • Total hours worked during the reporting period

Last edited: 25 August 2022 2:00 pm