General Practice Workforce, 30 September 2021 - Provisional

In August 2021 we revised the entire time series back to September 2015, making several methodological changes to the way in which the workforce numbers are calculated. Please refer to the Methodological Change Notice in the June 2021 publication.

The main element of these changes was the removal of fully estimated records (where a practice has not provided any data for a staff group). These estimates were calculated according to perceived levels of local need for each job role and were based upon national staffing patterns. This relied on all practices and CCGs having an equal need for staff in every job role. The creation of Primary Care Networks (PCNs) in 2019 introduced significant changes to the national primary care workforce. PCNs work collaboratively with general practices and other health and social care providers and share staff – primarily in the DPC group – across the network. This means that it is increasingly likely that PCNs will employ DPC staff and that fully estimated records will inflate figures for this particular staff group.

Following stakeholder feedback and the move to monthly publications we are reviewing the implementation of these changes, the impact on the time series and the length of time series included in each of these new monthly publications. Until this review is complete, all published figures remain provisional and we will not be presenting a full-time series. The time series will be reinstated once the review has been concluded and a methodology agreed.

The review into the methodology has centred around the removal of fully estimated staff records, which were calculated for practices which did not submit any data, or any valid data, for an entire staff group.

This review is a result of feedback which expressed concerns over the effect that removing estimates would have on year-to-year comparisons of workforce figures since the coverage of the data has increased over time.

The review is not yet completed, however the following presents an update on progress so far and next steps.

The review aims to answer two main questions:

1. Was the removal of these estimates and redefinition of the entire historical timeseries the most appropriate solution for ensuring an accurate and consistent timeseries?
2. How appropriate would it be to estimate for missing staff, given near complete data and a changed primary care landscape with the formation of Primary Care Networks, who may now be employing these staff - particularly those in the Direct Patient Care staff group?

Question 1

Testing the estimation methodology on historical data

This is being done in two ways.

• Calculate the England average job role to registered patient ratio based on all supplied data. Apply the estimation methodology, using this ratio, to calculate an estimated headcount and FTE for each job role at each practice, and compare the results to the submitted data. We are also investigating whether calculating CCG-level job role to registered patient ratios would produce better results than an England-level figure.
• Compare the data submitted by practices who came onboard the NWRS collection tool after the start of the time series, with the job role headcount and FTE that would have been estimated for them before they began to give us information about their staff.

Question 2

Our Data Liaison Service has been contacting practices who do not currently submit data about some or all staff groups. This includes practices who have no records at all within NWRS for a staff group, and others who do have staff records but they either all fail validation, or all relate to staff members who have been recorded as leavers.

Questions put to these practices have been designed to ascertain whether they genuinely do not have staff members working in each of the staff groups that they have no data for.  It is also hoped this piece of work will encourage practices not submitting data to do so, and for those with invalid staff records to investigate and correct them.

Next steps

This review will help us to formulate proposals on:

• Whether or not estimations should be reinstated, and for which staff groups
• If they are reinstated for some or all staff groups, whether the same methodology or a new calculation should be used
• Up to what point in the timeseries should estimations be reinstated, if at all, and whether estimations are required for current data and for future releases
• Given the increase in frequency of the publications – from quarterly to monthly – what period should be included as a consistent time series in these publications
• Further updates will be provided here before the next publication of general practice workforce data in December.