CCGs were asked to provide details of commissioned GP hours for the settings specified. Some CCGs were unable to supply details of commissioned hours but instead entered provided (actual) or rota’d hours or an estimate. Some CCGs commented in the free-text field of the template, that commissioned and actual hours may be very different or that they commissioned according to need rather than for a set number of hours.
Use of the flags to identify that the CCG had commissioned a service, provided actual or rota’d hours or submitted estimated figures has given us more information about commissioning activity but increased uncertainty about the reliability of the figures provided.
62 CCGs flagged at least one of their providers as delivering a service in which the GP hours may not necessarily be specified or identifiable. Of these CCGs, 58 nonetheless entered hours for 120 flagged providers and the submitted hours were included in the calculations to estimate FTE GP counts. We recognise that it is possible that these hours, which equate to an estimated 550 FTE GPs (figures from the remaining four CCGs were excluded for data quality purposes or null values) may not be limited to those delivered by GPs but could include all staff delivering patient care. These 550 FTE GPs compare to an estimated 440 FTE GPs from 23 CCGs (and 65 providers) April to June 2019 where comments provided in the free-text field noted that provision is commissioned as a service. Again, users are urged to interpret all these FTE estimates with care.
82 CCGs said they had entered actual, rota’d, rostered or a combination of all of these types of hours for one or more provider while 48 estimated figures for one or more service provider. Some CCGs flagged their data against multiple categories further reducing confidence in the figures’ reliability.
CCGs do not necessarily commission services for every setting. Of the five main categories, (Extended Access, out-of-hours, 111/IUC, Type 1/2 GP Streaming and UTC/MIU/Type 3/4 GP Streaming), only six CCGs entered counts against all five while 71 provided figures for only one.
Where a CCG did not provide figures for a particular setting, we do not know whether this is because they do not commission GP hours in these settings or because the data are not available. Because of the very wide variation in the way in which such services are commissioned by CCGs, it is not possible or appropriate to estimate for missing data or to make any assumptions about provision in one area or region based upon the submissions of another.
The FTE estimates in the Results section are therefore based upon a combination of commissioned, actual and estimated figures and should be treated with caution. Furthermore, because the figures provided are estimated full-time equivalent counts derived from this hours data, they should not be used to draw any definitive conclusions about the general practitioner workforce and must not be added to counts published elsewhere to make assumptions about the capacity of general practices within the primary care sector.