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Publication, Part of

General Practice Workforce - 31 March 2020

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 31 Mar 2020

Report

Introduction

This publication presents statistics relating to the general practice workforce in England as at 31 March 2020.

Accompanying this publication are the following additional files and tools to enable further analysis:

  • September 2015 to March 2020: High-level figures in the Excel tables and the Power BI dashboard
  • March 2020 only: Regional figures in the Excel tables.
  • March 2020 only: Individual and Practice-level data in the Comma Separated Values (CSV) files.

We are keen to ensure that our reports 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, please include "GP Workforce" in the subject line of your email.

Overview

These General Practice Workforce statistics are relatively new, following the introduction of a new primary data source in September 2015 and any figures published within this series are not comparable with figures from earlier years.

We now use two main data sources to produce these statistics. The workforce Minimum Data Set (wMDS) collected directly from general practices via the National Workforce Reporting System (NWRS) data entry module provides information on all staff except GP Registrars. Until January 2019, some figures were supplied to us directly by Health Education England regions, but the NWRS has included this HEE data since March 2019 making it the main data source for the general practice workforce.

All information relating to GP registrars is taken from the Health Education England (HEE) Trainee Information System (TIS) which has been our primary data source since June 2018, as it provides more complete and timely data than the Electronic Staff Record (ESR) which was the main source of our GP registrar data up to that point. A comparison of the TIS and ESR data sets enabled us to calculate estimates for GP registrar counts back to September 2015 to produce a more consistent national time series although regional comparisons cannot be made prior to June 2018.

In addition to the estimates for GP registrars prior to June 2018, we have also produced estimated figures for GP locums and revised our entire full-time equivalent time series in November 2019 which relates to statistics for September 2015 to September 2019. This means that the figures released in November 2019 supersede earlier releases and because the figures are not comparable, we have archived these publications to avoid confusion. More information about these estimates and the methodologies is in the General Practice Workforce 30 September 2019 publication, released 28 November 2019 and details on GP registrar data source and estimations methodology are in the Data Quality Statement accompanying the publication of December 2018 data. Information about changes to GP locum time series is available in the Data Quality Statement accompanying the publication of September 2019 data.

More information is also available in What this publication can tell you about.

Not all GP practices provide valid data which means some figures are estimated. For the March 2020 data 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.  Full-time equivalent (FTE) figures were also estimated for otherwise valid records with no submitted hours, which affected GP records in 5.4% of practices in March 2020. 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.

From July 2019 GP practices have been joining with other health and care providers to form Primary Care Networks (PCNs) and will work collaboratively with network members to strengthen primary care. Since that time, Clinical Directors for the PCNs have been recruited and information about these individuals was included in the September and December 2019 publications. However, a PCN specific data collection has now been created and information on Clinical Directors and other PCN staff will now be published in a Primary Care Network Workforce series of Official Statistics. However, the transfer of records between practices and PCNs is still ongoing and figures for some Clinical Directors are still included in a separate table in this release.

More information on these changes can be found in the accompanying Data Quality Statement and on the March 2020 Data Quality tab.

Following stakeholder feedback and in light of changes to the way in which users engage with data and information, we are reviewing 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.

Information on upcoming changes, to take effect in the publication of June 2020 data, can be found in the notice of vhanges tab. 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/or 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, March 2019 and 2020

 

 

March 2019

March 2020

GPs

Full estimation

1.8%

1.5%

 

Partial estimation

4.6%

5.4%

Nurses

Full estimation

3.4%

3.7%

 

Partial estimation

2.2%

2.7%

Direct Patient Care

Full estimation

19.8%

17.3%

 

Partial estimation

2.5%

2.8%

Admin/Non-clinical

Full estimation

1.8%

1.3%

 

Partial estimation

9.2%

9.1%

Using this publication

It is not always possible or appropriate to compare figures over time, depending on how they were originally calculated. 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 when GP data began to be collected quarterly. Data for the other staff groups has been collected quarterly since December 2017.

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?

We have done our utmost to remove breaks in the time series to allow GP counts to be comparable – as far as possible – across years. This means that our FTE GP time series is available back to September 2015 and published figures may reasonably be compared with those from the same point in previous years. The headcount GP time series is comparable from December 2017 onwards, although we continue to include headcount figures back to September 2015.

Details of the work we have done to remove time series breaks and support comparability are available in the  General Practice Workforce 30 September 2019 publication and the figures in that release supersede all earlier publications. However, in summary:

  1. Revisions to the estimation methodology
    We revised how we estimate for missing or incomplete records for the December 2018 data collection and revised all historical figures back to September 2015 in that publication which was released in two instalments on 21 February and 25 April 2019.
     
  2. GP registrars:  
    We began using the Health Education England Trainee Information System (TIS) as the source of our GP registrar data from June 2018 onwards and used this more reliable data to estimate for missing records at England-level only for September 2015 to March 2018.
    However, regional figures for September 2015 to March 2018 remain noncomparable with the figures from June 2018 onwards as there is no information about the regional location of large numbers of GP registrars prior to June 2018.
     
  3. GP locums
    The GP locum time series – and hence the overall GP time series – had two series breaks. These breaks resulted from the release of additional data collection guidance early in 2017 and a change to the data collection between September and December 2017 when we began collecting information on “infrequent locums” who may cover as little as a single session at a GP practice.
    We have been able to produce estimates for FTE GP locums to account for under-reported figures, meaning all GP FTE figures are now comparable with those for the same reporting point in previous years back to September 2015.
    However, because of the way some of the GP locum information is collected, we are unable to estimate for the number of individuals these FTE figures may represent and therefore cannot produce estimated headcount figures for these GP locums. This means that the headcount GP locum – and overall headcount GP figures – are not comparable with any figures prior to December 2017.
     

As the figures in the General Practice Workforce 30 September 2019 publication, released on 28 November 2019, superseded all earlier releases, we have archived older publications to avoid confusion.  

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 at England-level can now be compared from September 2015 to current following the removal of breaks in the time series.  However, regional comparisons of figures prior to June 2018 are not possible because there is no regional information for a large number of GP registrars whose location is therefore recorded as “Unknown” for September 2015 to March 2018.

All GP headcount data at England-level can be compared for figures from December 2017 onwards. Again, regional comparisons from June 2018 onwards cannot be compared with earlier figures due to missing regional information about the GP registrars.

At England-level, GP headcount figures excluding locums can be compared from September 2015 onwards, while the regional figures are comparable from June 2018 only due to the missing location information for GP registrars.

The GP regional FTE and headcount figures excluding locums and registrars can be compared from September 2015 to current.

The Nurses data in this publication can be compared across time periods. At a job role level, we recommend that caution be used, as staff previously classified as District Nurses were 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. However, 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 in the early collections.

More detail about these changes are in the relevant table footnotes. Table 2 indicates where data is and is not comparable, to March 2020.

Table 2: Earliest date in this publication where figures are on the same basis as March 2020.

General Practitioner groupings:

From (England-level)

From (Region-level)

    All GPs

Sep-15 FTE, Dec-17 HeadcountA,B

Jun-18C

    Fully Qualified GPs (excludes Registrars)

Sep-15 FTE, Dec-17 HeadcountA

Sep-15 FTE, Dec-17 HeadcountA

    Regular GPs (excludes Locums)

Sep-15B

Jun-18C

    Qualified Permanent GPs (excludes Registrars & Locums)

Sep-15

Sep-15

General Practitioner job roles:

 

 

     GP Partners

Sep-15

Sep-15

     Salaried GPs

Sep-15

Sep-15

     GP Registrars

Sep-15B

Jun-18C

     GP Retainers

Sep-15

Sep-15

     GP Locums

Sep-15 FTE, Dec-17 HeadcountA

Sep-15 FTE, Dec-17 HeadcountA

Other Staff Groups:

 

 

    All Nurses

Sep-15

Sep-15

    All Direct Patient Care

Sep-15

Sep-15

    All Admin/non-Clinical

Sep-15

Sep-15

A 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.

C Change in data source of GP registrars led to a notable reduction in registrars of 'unknown' location and region.

 

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. In 2019 experimental statistics for General Practitioners in Alternative Settings were published in the General Practitioner Workforce in Alternative Settings series. However, due to data quality concerns we have been unable to continue with this publication, although high-level counts may continue to be released as management information on the Supplementary Information section of our website at https://digital.nhs.uk/data-and-information/find-data-and-publications/supplementary-information.

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

Not all doctors who hold the specialty 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 is released 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.

These PCNs will employ their own workforce which will include an accountable Clinical Director along with specialist staff such as clinical pharmacists, social prescribing link workers, physiotherapists, podiatrists, dietitians and physician associates.  We first began officially collecting data on the PCN workforce in March 2020 but information on some Clinical Directors was published for September and December 2019 in a separate table in this series.  As there have been some delays in transferring staff records to PCNs, we have again included some figures on Clinical Directors in a separate table.  However, work is ongoing to gain an understanding of these new PCNs and we have published new experimental statistics in the Primary Care Network Workforce series.

 

Last edited: 24 August 2020 11:25 am