Primary Care Workforce Quarterly Update, 31 December 2022, Experimental Statistics

Full-time equivalent (FTE) is calculated based upon a 37.5 hour working week. For example, a staff member working 15 hours per week would be 0.4 FTE while someone working four 7.5-hour days would be 0.8 FTE and so on.

Practices and PCNs are asked to submit the number of contracted weekly hours for an individual, but also have the option to submit average weekly hours worked across the period (which since July 2021, is a month), separately. This option is of particular importance where contracted hours would not be relevant for an individual (for example, where the staff member is on a zero hours contract).

We calculate the FTE for each record based on these fields. For the majority of staff we use contracted hours in the first instance, only using working hours if contracted hours is missing or zero. If both fields are missing or zero, we estimate the FTE for the individual if they are part of the general practice workforce, or exclude them entirely them if they are part of the PCN workforce.

The exception to this rule is those individuals on either a zero hours contract, or a partner (zero hours) contract. For these staff, we calculate FTE based on their working hours in the first instance, but use contracted hours if working hours is missing or zero. If both fields are missing or zero, these individuals are excluded from the analysis and do not count towards the FTE figures.

For the Primary Care Workforce FTE (NWRS only) tables in this publication, data is aggregated from the latest PCN and General Practice NWRS based publications to get the total FTE in post for each job role. Where the role is common across the two primary care settings, the FTE presented reflects the combined general practice and PCN FTE for that role. Where a role is unique to one setting or the other, the FTE will be the same as published in the relevant publication.

NWRS figures are calculated at PCN level (combining practice and PCN data, net of baseline), and compared to the first available FTE data in the claims submitted by that PCN (approximately five weeks after month end), taking the higher of the two values.

Step 1 – combine NWRS general practice and PCN workforce data

Data is aggregated from the latest PCN and General Practice NWRS based publications to get total DPC staff FTE in post for each job role for each PCN. Only records based on known individuals are included, with FTE from fully-estimated records in the General Practice publication excluded. Practice figures are aggregated up to PCN level. For data from practices not aligned to PCNs, a separate category of “unaligned” is presented for each role in each Sub-ICB Location (effectively treated as an extra PCN which has 0 ARRS recruitment per Sub-ICB Location) – see section below for further detail.

Step 2 – produce collated NWRS/ARRS claims figures net of baseline figures

For each role in each PCN/Sub-ICB Location, subtract Q4 2018/19 Practice NWRS figures from total to give FTE figures net of baseline.

For each role in each PCN, compare net FTE from NWRS to FTE in Claims data (don’t need to include figures from unaligned practices for this part, since they won’t have any ARRS claims):

• Where net NWRS figure is >=0, compare to equivalent most recent month’s Claims data for that role/PCN.
• Where most recent month’s Claims data is >0, use whichever of net NWRS and Claims figures is higher.
• Where net NWRS figure is <0, use NWRS figure.
• Aggregate figures for each role up to Sub-ICB Location-level and add NWRS DPC FTE figures from unaligned practices.

Unaligned Practices

To cover DPC staff at practices in that Sub-ICB Location which are not aligned to a PCN, published data will include one Unaligned category per Job Role and Sub-ICB Location. This will present in the data as an extra PCN which only has practice staff.

NWRS data recorded for practices which were previously part of PCNs which have since closed will also be reported under Unaligned. Where there is Claims FTE data against a PCN which was closed prior to the claim month, that FTE data will be excluded from the analysis.

Baseline

As the collated figure is calculated at PCN level, the March 2019 NWRS FTE for each job role  - which relates to the general practice workforce - must be attributed to PCNs. For this reason, practices in the 2019 NWRS GP workforce data are mapped to PCNs. As PCNs did not exist at that time, we use the practice-to-PCN relationship that is active for the latest reporting period.

This means that for each release, it is possible that the March 2019 baseline FTE can change at sub-national level. This will happen where a practice moves to a PCN that is in a different Sub-ICB Location/ICB/Region. In these instances, the FTE reported by that practice will move from one Sub-ICB Location/ICB/Region to another. England-level figures are unaffected.

Role comparisons

NWRS and the claims portal do not use the exact same terminology for all roles. The two sets of job role descriptions are mapped. Not all ARRS roles are currently available in the NWRS, notably Mental Health Practitioners, Digital and Transformation Leads and General Practice Assistants. The differences are as follows:

Where Advanced Practitioners (AP) do not appear in NWRS they have been excluded from the collated figure to avoid the risk of double counting (where PCNs may have been recording them in the NWRS under their specific non-AP role). Where they do appear in NWRS, and up to and including September 2022, they have been combined into a single AP category to align with how they appeared in the ARRS data. From December 2022 the advanced practitioner roles were separated in the ARRS claims data and consequently, in these publication tables. The six advanced practitioner roles are: Advanced Clinical Pharmacist Practitioners, Advanced  Physiotherapist Practitioners, Advanced  Dietitian Practitioners, Advanced  Podiatrist Practitioners, Advanced  Occupational Therapist Practitioners and Advanced  Paramedic Practitioners

Until Mental Health Practitioners, Digital and Transformation Leads and General Practice Assistants, or any other ARRS roles currently not in NWRS, are introduced to it, they have been excluded from the collated figure to avoid the risk of double counting (where PCNs may have been recording them in the NWRS under Other DPC, for example).

Release frequency

This publication is released quarterly, presenting statistics relating to June, September, December and March of each year. Data will be made available for September 2021 onwards to coincide with the first data being available from the NWRS tool being brought in-house at NHS Digital.

Use of Estimates

The Primary Care Network FTE figures do not include estimates for staff records with no contracted or worked hours recorded (partial estimates), or where PCNs have not provided usable data for an entire staff group (full estimates). General Practice figures do include both full and partial estimates. The methodology used to produce these estimates can be found on the GP Monthly publication pages

https://digital.nhs.uk/data-and-information/publications/statistical/general-and-personal-medical-services/31-december-2021/methodology-review-and-changes

For the NWRS data used to calculate the collated figure, full estimates have been excluded and only partial estimates from the general practice workforce have been used.