General Practice Workforce 31 December 2019

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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 methodology: A 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. The new locum FTE figures for September 2015 to December 2016 are not comparable with earlier figures published prior to 28 November 2019 and all the figures released in the General Practice Workforce 30 September 2019 publication supersede the earlier releases.

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 both 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 December 2019.

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.

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.

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. 

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. Initial information on Clinical Directors employed within PCNs is provided in a separate table within this release.