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Publication, Part of

General Practice Workforce 30 September 2019

Official statistics
Publication Date:
Geographic Coverage:
England
Geographical Granularity:
GP practices, Clinical Commissioning Groups, Sustainability and Transformation Partnerships, Regional health body, Regions, Health Education England Region, Primary Care Organisations
Date Range:
30 Sep 2015 to 30 Sep 2019

Report

Introduction

This publication presents data relating to the general practice workforce in England, statistics as at 30 September 2019.

Accompanying this publication are additional files and tools to enable further analysis, these are:

  • September 2015 to September 2019: High-level figures in the Excel tables and the Power BI dashboard
  • September 2019 only: Regional figures in the Excel tables, and Individual and Practice-level data in the Comma Separated Values (CSV) files.

General Practice (GP) Workforce statistics are relatively new and we are keen to ensure that they are as useful and relevant as possible for our users. We are therefore continually working to improve the quality of the data and analysis. Changes can include improving the coverage, completeness or accuracy of the data, or revising elements of the methodology and are made in consultation with colleagues, including within the Department of Health and Social Care (DHSC), NHS England and NHS Improvement (NHSEI) and Health Education England (HEE). We welcome feedback from all our users and you can get in touch with us at PrimaryCareWorkforce@nhs.net

Overview

The primary data source for General Practice Workforce statistics changed in September 2015 from the National Health Authority Information System (NHAIS) to the wMDS (Workforce Minimum Data Set) collected via the National Workforce Reporting System (NWRS) data entry module and four HEE Regional Tools whose data was submitted to NHS Digital via the workforce Minimum Data Set Collection Vehicle (wMDSCV) until March 2019.

From March 2019, the main data source for this collection is the NWRS. Since January 2019 data is no longer received on behalf of any practices via HEE Region Tools, with all data collection (excluding GP registrars) taking place through the NWRS.

For the September 2019 collection 98.5% of eligible general practices provided valid GP data for non-registrar GPs, with GP data for the remaining 1.5% of practices estimated.  FTE figures were also estimated for otherwise valid records with no submitted hours, which affected GP records in 5.4% of practices in September 2019. More information about the estimation methodology can be found in the Data Quality Statement that accompanies this publication; the estimation rates for all four staff groups can be found under Estimation Rates below

GP registrar data has been taken from the Health Education England (HEE) Trainee Information System (TIS) since June 2018 and is extracted where the record indicates that the trainee is currently on an active placement in General Practice. Prior to this, registrar data were compiled using a combination of the NWRS and HEE tools, and the Electronic Staff Record system (ESR). Comparison work based on June 2018 data using the old and new sources, has resulted in adjustments to pre-June 2018 figures that now enable indicative comparisons of GPs including registrars to be made across the time series

The change in the data source for GP registrars has enabled us to produce more timely and accurate information which has removed the need to release provisional and then final figures. All data is now final at publication.

Since June 2018, GP registrar data is taken from the HEE TIS system removing any need for GP registrar estimations.

Following a consultation in 2018, several revisions to our data processing and methodology were implemented for the publication of December 2018 data which are detailed in the Data Quality Statement that accompanies that release. As a result of these changes, revised figures from September 2015 to September 2018 were published in two instalments on 21 February and 25 April 2019. Please refer to the December 2018 publication for more information.

Please note: The figures produced under the new methodology are not comparable with earlier figures published prior to 21 February 2019.

Following recent investigations into the GP Locum data within this collection, we have revised the Full-Time Equivalent (FTE) figures for GP Locums in September 2015, March 2016, September 2016 and December 2016. Revised England-level GP Locum FTE figures for September 2015 to December 2016 have been included in this publication, and the previous breaks in the time series have been removed. Revised regional GP locum FTE figures will be produced in due course, where applicable, and for this publication will be displayed as of Unknown region in the accompanying Power BI dashboard. The GP headcount time series remains unaltered as the methodology used accounted for the level of work undertaken which is represented by FTE; we are unable to make assumptions about headcount from this due to changing locum working patterns.

Please note: The new locum FTE figures for September 2015 to December 2016 are not comparable with earlier figures published prior to 28 November 2019.

We have also made changes to the GP Joiners and Leavers methodology, after an initial review of the data and existing methodology. The revised figures can be found within the Supplementary Tables of this publication. Further work will continue in this area.

With the recent introduction of Primary Care Networks (PCNs), information on Clinical Directors registered within the PCNs has formed part of the September 2019 collection and is provided within the Supplementary Tables of this release.

More information on these changes can be found in the accompanying Data Quality Statement.

Following stakeholder feedback and in light of changes to the way in which users engage with data and information, we will undertake a review of the publication content and outputs with a view to streamlining its contents and standardising the release.  As a result of this activity, it is likely that in addition to open data, we will encourage greater use of interactive resources to enable our users to interrogate the data according to their particular needs.

We welcome feedback, by email to PrimaryCareWorkforce@nhs.net

 

Estimation rates

Estimates are made for both headcount and Full-Time Equivalent (FTE) for those practices which did not provide complete and valid data for one of the four staff groups; this could be due to poor data quality or no submitted data.

Full Estimation - practices who provided no valid data for one or more staff groups. For these practices CCG-level estimations were made.

Partial Estimation - practices whose data contained one or more otherwise valid records with no submitted hours. These records were retained and the Full-Time Equivalent (FTE) estimated.

Table 1: Percentage of practices with estimated records, September 2018 and 2019

 

 

September 2018

September 2019

GPs

Full estimation

2.4%

1.5%

 

Partial estimation

4.9%

5.4%

Nurses

Full estimation

3.8%

3.4%

 

Partial estimation

3.0%

2.8%

Direct Patient Care

Full estimation

20.5%

18.5%

 

Partial estimation

2.6%

3.1%

Admin/Non-clinical

Full estimation

1.9%

1.4%

 

Partial estimation

9.5%

10.0%

Using this publication

It is not always possible to compare figures over time, based on how they were originally published. Where this is the case, clear indications have been included in the publication(s) and associated supporting material. Sometimes we may advise that comparisons might be made with caution, knowing that the impact of these changes is small. We will always aim to give guidance on how to interpret any changes in the series, to ensure time series comparability is as clear as possible.

These statistics are now produced on a quarterly basis, with the time series going back to September 2015 when this data collection was first made. The collection was initially biannual, until December 2016.

What this publication can tell you about

When comparing GP workforce statistics, we always advise that any comparisons are made across a full year rather than from one quarter to the next. This is because quarterly data is affected by seasonality. For example, September is the main intake and rotation period for registrars, which can result in a higher number of registrars joining the practices than leaving. Similarly, some registrars may leave, or rotate away from practices, over the subsequent quarters.

 

Can historical comparisons be made?

There have been several changes over recent years, which affect the ability to compare GP numbers between reporting periods.  When interpreting these statistics users need to consider the following changes and their impact on the time series:

  1. Revisions to the estimation methodologyA new estimation methodology was implemented for the December 2018 data collection and all historical figures back to September 2015 were revised when the publication was released in two instalments on 21 February and 25 April 2019.
    The figures produced using this new methodology are not comparable with any published prior to 21 February 2019.
  2. GP registrars:  Registrar information changed data source between March and June 2018. Estimates have been produced for September 2015 to March 2018 figures based on the difference between the old and new registrar data sources, that enable indicative comparisons to be made across the full time series.
  3. GP locums:  The GP locum time series had two breaks as described below. The breaks in the time series have now been removed for full-time equivalent (FTE) totals but not for headcount.
    The first break was between December 2016 and March 2017, when practices were provided with improved guidance on completing GP locum data in the collection tool, after which there was a notable increase in the number of locums recorded which was attributed primarily to the new guidance. After a thorough investigation, new FTE estimates have been applied to the September 2015 to December 2016 locum figures and the break in the FTE time series was therefore removed.
    The second break was between September and December 2017, when a new “infrequent locum” job category was included following the addition of a new module in the collection tool. A recent review has concluded that this change had a very small impact on the FTE figures and therefore the break in the GP locum FTE time series at that point has been removed.

    Therefore, the FTE GP locum and All GPs time series are now comparable from September 2015 to current.

More details on all these changes and areas of exploratory work can be found in the accompanying Data Quality Statement.

 

Where data can be compared

All GP FTE data can now be compared from September 2015 to current with the removal of both previous breaks in the time series,  following the adjustments made to GP locum data for the first four collections.

All GP headcount data can be compared from December 2017 to current, due to the earlier changes in the level of locum reporting and the introduction of the infrequent locum recording.

However, the GP headcount figures excluding locums can be compared from September 2015 to current as adjustments have been applied to the earlier locum figures as detailed above, and to September 2015 to March 2018 figures to account for a change in data source for registrars. 

The Nurses data in this publication can be compared across time periods. At a job role level, we advise caution is used as staff previously counted as District Nurses have been re-categorised as Practice Nurses from June 2019.

The overall Direct Patient Care, and Admin/non-Clinical figures in this publication can be compared from September 2015 to current. The job role level data is not fully comparable due to changing job roles in the collection tools and the existence of some records with no stated job role.

More detail about these changes can be found in the relevant table footnotes. Table 2 indicates where data is and is not comparable, to September 2019.

Table 2: Earliest date in this publication where data are on the same basis as September 2019.

General Practitioner groupings:

From

    All GPs

Sep-15 FTE, Dec-17 HeadcountA,B

    Fully Qualified GPs (excludes Registrars)

Sep-15 FTE, Dec-17 HeadcountA

    Regular GPs (excludes Locums)

Sep-15B

    Qualified Permanent GPs (excludes Registrars & Locums)

Sep-15

General Practitioner job roles:

 

     GP Partners

Sep-15

     Salaried GPs

Sep-15

     GP Registrars

Sep-15B

     GP Retainers

Sep-15

     GP Locums

Sep-15 FTE, Dec-17 HeadcountA

Other Staff Groups:

 

    All Nurses

Sep-15

    All Direct Patient Care

Sep-15

    All Admin/non-Clinical

Sep-15

Adjustment applied to September 2015 to December 2016 data to account for an improvement in GP locum recording.

B Adjustment applied to September 2015 to March 2018 data to account for a changing data source for GP registrars.

 

Included in the published information

Workforce information is included for all staff providing services at a traditional General Practice, which we define as an organisation which offers Primary Care medical services by a qualified General Practitioner who can prescribe medicine and where patients can be registered and held on a list. Generally, the term describes what is traditionally thought of to be a high street family doctor’s surgery. Definitions of each job role can be found in the NWRS User Guidance.

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 and Walk-In Centres, although the increasing trend for Walk-In Centres to develop as Equal Access Treatment Centres that register patients now makes it harder to differentiate between these sites and traditional general practices. It also does not include other alternative settings outside of traditional general practice such as urgent treatment centres and minor injury units.

What this publication cannot tell you about

Settings other than General Practices

This publication does not contain workforce information on primary care staff providing services at Prisons, Army Bases, Educational Establishments, Specialist Care Centres including Drug Rehabilitation Centres and Walk-In Centres. However, work is ongoing to build an understanding of primary care staff in some of these alternative settings. New experimental statistics for General Practitioners in Alternative Settings have been published in the General Practitioner Workforce in Alternative Settings series.

Doctors whose speciality is General Practitioner but are not working in General Practice

Not all doctors who hold the speciality of General Practitioner are recorded in this publication. Those providing services in the Hospital and Community Health Services (HCHS) or in the Independent sector are not counted in this publication.  HCHS workforce data is published as part of the NHS Workforce Statistics series, and Independent sector data in the Independent Healthcare Provider Workforce Statistics series.

Primary Care Networks

From July 2019, most GP practices will belong to a Primary Care Network (PCN) which will offer a range of primary care services to patients and employ new specialist staff such as clinical pharmacists, social prescribing link workers, physiotherapists, physician associates and paramedics.

Work is ongoing to gain an understanding of these new PCNs and how best to collect and report information on their workforce. In this publication initial information on Clinical Directors employed within PCNs can be found within the Supplementary Tables.

Last edited: 24 August 2020 11:35 am