General Practice trends in the UK to 2016 Published 19 September 2017 This paper collates information on General Practice trends in England, Wales, Scotland and Northern Ireland. The paper includes figures on country level workforce trends, practice numbers and list sizes and population projections and a breakdown of contract types in England. Key Findings In 2016 the number of GP practitioners (excluding registrars, retainers and locums) was: o 34,836 in England o 2,009 in Wales o 4,326 in Scotland and o 1,274 in Northern Ireland During the year, the number of GP practices decreased by 147 in England; 13 in Wales; 18 in Scotland and by five in Northern Ireland Female GP practitioners (excluding registrars, retainers and locums) accounted for over half of the GP practitioner workforce. Percentage of female GP practitioners, (excluding registrars, retainers and locums) 2010 to 2016 Percentage UK England Wales Scotland Northern Ireland 60 55 50 45 40 35 2010 2011 2012 2013 2014 2015 2016 Author: Workforce and Facilities, NHS Digital Responsible Statistician: Helen Lewis Copyright 2017 Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.
General Practice Trends in the UK to 2016 Contents Key Findings 1 Introduction 4 GP Trends in the UK 5 General Practice Staff 15 Breakdown of Contract Types for England 17 Data Sources 19 Definition of GPs 20 Copyright 2017, Health and Social Care Information Centre. 2
General Practice Trends in the UK to 2016 This product may be of interest to remuneration boards, employers, stakeholders, policy officials, commissioners and members of the public. Interests will range from comparisons of the NHS workforce at local, regional and national levels to managing recruitment, staffing and training and prioritising commissioning. Copyright 2017, Health and Social Care Information Centre. 3
General Practice Trends in the UK to 2016 Introduction The latest figures available for this report are for 2016 and these are taken from each country s General Practice publications and from the Office of National Statistics, which compiles and publishes population estimates for each of the UK constituent countries (see the Data Sources chapter for more information). All residential population figures are updated mid-year estimates for 2016, which have been revised and rebased using the 2011 Census. The differences between the figures for GP registered patients and residential population are expected and there are a number of reasons contributing to the differences. This GP list inflation may be caused, for example, by patients who have not been removed from patient lists following death, emigration or moving home, patients being dual registered at practices following a change of address or due to registered patients not completing the 2011 Census. GP numbers are across all contract types for each of the countries and the GP numbers that represent headcount do not therefore reflect changes in working patterns. Figures shown may differ from those previously published due to revised data and changes in data sources. Changes in data sources, unstated GP types and locum numbers In England the primary data source for General and Personal Medical statistics changed in September 2015 from the National Health Authority Information System (NHAIS) to the workforce Minimum Data Set (wmds) collected via the Primary Care Web Tool (PCWT) Workforce Census module and the workforce Minimum Data Set Collection Vehicle (wmdscv). Although data for England are now extracted on a quarterly basis, this report uses data that were collected shortly after 30 September and are considered to be a snapshot of GP practices as at 30 September 2016 in line with the previous NHAIS extracts. 92.4 per cent of eligible general practices provided data for the September 2016 collection; information for the remaining 7.6 per cent of practices has been estimated. In the previous year, 88.1 per cent of eligible general practices provided a return for the collection at 30 September 2015, and information for the remaining 11.9 per cent of practices was estimated. In 2015 there were 3,228 GPs in England that could not be identified as having a specific job role and as such their GP Type was classed as unstated. In 2016 the number of GPs of unstated GP Type was four. Figures have now been revised due to improvements in reporting systems carried out in 2017 and have resulted in all GPs recorded with a Not Stated job role in previous publications being allocated to their correct role retrospectively. In England the wmds collection also includes details of GP Locums working in general practice in England as at 30 September. In Wales data on GP Locums is sourced from the Medical Performers List, which lists all GPs that are registered to practice in Wales. Currently, no figures are available for GP Locums for Scotland and Northern Ireland. Copyright 2017, Health and Social Care Information Centre. 4
GP Trends in the UK Table 1: GP trends in the UK 2006 2007 2008 2009 2010 1 2011 2012 2013 2014 2015 2 2016 2 A B C D D/A E E/A Number of GP practices Number of GP providers 1,2,3,4 Number of other GPs 1,2,3,5 GP registered patients (millions) Average patients per practice Residential population (millions) 6 Average population per practice 10,212 10,145 10,112 10,096 10,185 10,158 9,912 9,777 9,674 9,458 9,275 34,351 34,035 34,068 34,345 33,753 33,891 33,567 33,272 32,835 31,420 r 30,385 5,857 6,596 7,273 8,958 9,013 9,354 9,663 9,981 10,765 11,801 r 12,164 r 63.593 63.939 64.382 65.108 65.574 65.895 66.368 66.673 67.179 67.933 68.670 6,227 6,303 6,367 6,449 6,438 6,487 6,696 6,819 6,944 7,183 7,404 60.827 61.319 61.824 62.261 62.760 63.285 63.705 64.106 64.597 65.110 65.648 5,956 6,044 6,114 6,167 6,162 6,230 6,427 6,557 6,677 6,884 7,078 1. In England, the headcount methodology is not fully comparable with data for years prior to 2010 due to improvements that make it a more stringent count of absolute staff numbers. Headcount totals are unlikely to equal the sum of components. Further information on the headcount methodology is available in http://content.digital.nhs.uk/pubs/genpermsmar17aa and http://digital.nhs.uk/pubs/genpermsaug17aa (containing revised figures). 2. In England, prior to 2015 figures were sourced from NHAIS GP Payments (Exeter) System. From 2015 figures are sourced from the workforce Minimum Dataset (wmds) and include estimates for practices that did not provide fully valid GP data. Sep 2015 11.9%, Sep 2016 7.6%. Further information is available in: http://content.digital.nhs.uk/pubs/genpermsmar17aa 3. The sum of GP Providers and Other GPs is not the total headcount or total number of GPs, as these tables exclude Registrars, Retainers and Locums. 4. Also includes salaried GPs in Northern Ireland. 5. For England, Wales and Scotland. 6. UK Population figures may not equal the sum of components due to rounding. r Figures revised following improvements in the reporting systems which have resulted in all GPs recorded with a Not Stated job role in previous publications being retrospectively allocated to their correct role. Copyright 2017, Health and Social Care Information Centre. 5
Table 2: GP trends in England 2006 2007 2008 2009 2010 1 2011 2012 2013 2014 2015 2 2016 2 A B C D D/A E E/A Number of GP practices Number of GP providers 1,2,3 Number of other GPs 1,2,3 GP registered patients (millions) Average patients per practice Residential population (millions) Average population per practice 8,325 8,261 8,230 8,228 8,324 8,316 8,088 7,962 7,875 7,674 7,527 27,691 27,342 27,347 27,613 27,036 27,218 26,886 26,635 26,183 24,826 r 23,937 5,400 6,022 6,663 8,304 8,319 8,585 8,898 9,153 9,885 10,775 r 10,988 r 53.284 53.588 53.945 54.609 55.019 55.308 55.737 56.007 56.470 57.170 57.847 6,400 6,487 6,555 6,637 6,610 6,651 6,891 7,034 7,171 7,450 7,685 50.965 51.381 51.816 52.196 52.643 53.107 53.494 53.866 54.317 54.786 55.268 6,122 6,220 6,296 6,344 6,324 6,386 6,614 6,765 6,897 7,139 7,343 1. The headcount methodology is not fully comparable with data for years prior to 2010 due to improvements that make it a more stringent count of absolute staff numbers. Headcount totals are unlikely to equal the sum of components. Further information on the headcount methodology is available in http://content.digital.nhs.uk/pubs/genpermsmar17aa and http://digital.nhs.uk/pubs/genpermsaug17aa (containing some revised figures). 2. In England, prior to 2015 figures were sourced from NHAIS GP Payments (Exeter) System. From 2015 figures are sourced from the workforce Minimum Dataset (wmds) and include estimates for practices that did not provide fully valid GP data. Sep 2015 11.9%, Sep 2016 7.6%. Further information is available in: http://content.digital.nhs.uk/pubs/genpermsmar17aa 3. The sum of GP Providers and Other GPs is not the total headcount or total number of GPs, as these tables exclude Registrars, Retainers and Locums. r Figures revised following improvements in the reporting systems which have resulted in all GPs recorded with a Not Stated job role in previous publications being retrospectively allocated to their correct role. Copyright 2017, Health and Social Care Information Centre. 6
Table 3: GP trends in Wales 2006 2007 2008 2009 2010 2011 2 2012 2 2013 2014 2015 2016 A B C D D/A E E/A Number of GP practices Number of GP providers 1,2 Number of other GPs 1,2 GP registered patients (millions) Average patients per practice Residential population (millions) Average population per practice 496 495 499 488 487 483 474 470 462 454 441 1,778 1,778 1,788 1,768 1,776 1,757 1,753 1,740 1,722 1,663 1,606 104 158 152 172 215 250 243 286 284 334 403 3.093 3.094 3.115 3.135 3.153 3.163 3.173 3.178 3.173 3.187 3.198 6,236 6,250 6,242 6,424 6,474 6,549 6,694 6,762 6,868 7,021 7,251 2.986 3.006 3.026 3.039 3.05 3.064 3.074 3.082 3.092 3.099 3.113 6,020 6,073 6,064 6,227 6,263 6,343 6,485 6,558 6,693 6,826 7,059 1. The sum of GP Providers and Other GPs is not the total headcount or total number of GPs, as these tables exclude Registrars, Retainers and Locums. 2. Administrative errors were identified relating to the 2011 and 2012 GP Provider and GP Other headcount figures for Wales. Consequently, the figures shown were revised and were first published in General Practice Trend in the UK (to 2013) Table 4: GP trends in Scotland 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 A B C D D/A E E/A Number of GP practices Number of GP perfomers 1 Number of other GPs 1 GP registered patients (millions) Average patients per practice Residential population (millions) Average population per practice 1,028 1,027 1,025 1,023 1,019 1,006 997 994 987 981 963 3,772 3,787 3,785 3,808 3,781 3,753 3,758 3,726 3,719 3,657 3,568 353 416 458 482 479 519 522 542 596 692 773 5.406 5.424 5.474 5.497 5.519 5.527 5.549 5.568 5.599 5.627 5.663 5,259 5,282 5,341 5,373 5,416 5,494 5,566 5,602 5,673 5,736 5,881 5.133 5.170 5.203 5.232 5.262 5.300 5.314 5.328 5.348 5.373 5.405 4,993 5,034 5,076 5,114 5,164 5,268 5,330 5,360 5,418 5,477 5,612 1. The sum of Performer GPs and Other GPs is not the total headcount or total number of GPs, as these tables exclude Registrars, Retainers and Locums. Copyright 2017, Health and Social Care Information Centre. 7
Table 5: GP trends in Northern Ireland 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 A Number of GP practices 363 362 358 357 355 353 353 351 350 349 344 B Number of GPs 1 1,110 1,128 1,148 1,156 1,160 1,163 1,170 1,171 1,211 1,274 1,274 C D D/A E E/A Number of other GPs GP registered patients (millions) Average patients per practice Residential population (millions) Average population per practice : : : : : : : : : : : 1.81 1.833 1.849 1.867 1.883 1.897 1.908 1.919 1.937 1.948 1.961 4,986 5,063 5,164 5,230 5,305 5,374 5,406 5,467 5,533 5,582 5,701 1.743 1.762 1.779 1.793 1.805 1.814 1.824 1.83 1.841 1.852 1.862 4,802 4,867 4,970 5,023 5,084 5,140 5,166 5,213 5,259 5,305 5,413 1. The number of GPs is not the total headcount or total number of GPs, as these tables exclude Registrars, Retainers and Locums. Also includes salaried GP. Copyright 2017, Health and Social Care Information Centre. 8
Table 6: GP trends by gender and GP type, headcount, and registered patients per practitioner in England 2006 2007 2008 2009 2010 1 2011 2012 2013 2014 2015 2016 GP Headcount 1 GP Practitioners (excluding Locums) GP Practitioners (excluding Registrars, Retainers & Locums) 36,008 36,420 37,720 40,269 39,409 40,008 40,463 40,236 41,105 40,648 r 40,490 33,091 33,364 34,010 35,917 35,120 35,415 35,527 35,561 35,819 35,516 r 34,836 GP Providers 27,691 27,342 27,347 27,613 27,036 27,218 26,886 26,635 26,183 24,826 r 23,937 Other GPs 5,400 6,022 6,663 8,304 8,319 8,585 8,898 9,153 9,885 10,775 r 10,988 r GP Locums 2 : : : : : : : : : 1,370 r 1,561 GP Headcount Male 3 GP Practitioners (excluding Locums) GP Practitioners (excluding Registrars, Retainers & Locums) 20,452 20,365 20,698 21,708 20,832 20,740 20,468 19,801 19,571 16,181 r 15,989 19,541 19,361 19,420 20,207 19,314 19,130 18,804 18,330 17,931 14,700 r 14,310 GP Providers 17,692 17,381 17,249 17,288 16,697 16,568 16,136 15,748 15,186 12,306 r 11,768 Other GPs 1,849 1,980 2,171 2,919 2,761 2,791 2,813 2,716 2,885 2436 r 2,587 r GP Locums 2 : : : : : : : : : 664 r 701 GP Headcount Female 3 GP Practitioners (excluding Locums) GP Practitioners (excluding Registrars, Retainers & Locums) 15,556 16,055 17,022 18,561 18,577 19,268 19,995 20,435 21,534 19,252 r 19,502 13,550 14,003 14,590 15,710 15,806 16,285 16,723 17,231 17,888 15,838 r 15,814 GP Providers 9,999 9,961 10,098 10,325 10,339 10,650 10,750 10,887 10,997 9,355 r 8,938 Other GPs 3,551 4,042 4,492 5,385 5,558 5,794 6,085 6,437 7,000 6,524 r 6,914 r GP Locums 2 : : : : : : : : : 610 r 647 Copyright 2017, Health and Social Care Information Centre. 9
2006 2007 2008 2009 2010 1 2011 2012 2013 2014 2015 2016 Percentage of GPs that are female GP Practitioners (excluding Locums) GP Practitioners (excluding Registrars, Retainers & Locums) 43.2 44.1 45.1 46.1 47.1 48.2 49.4 50.8 52.4 54.3 r 54.9 40.9 42.0 42.9 43.7 45.0 46.0 47.1 48.5 49.9 51.9 r 52.5 GP Providers 36.1 36.4 36.9 37.4 38.2 39.1 40.0 40.9 42.0 43.2 r 43.2 Other GPs 65.8 67.1 67.4 64.8 66.8 67.5 68.4 70.3 70.8 72.8 r 72.8 r GP Locums 2 : : : : : : : : : 47.9 r 48.0 Unknown Gender 3 GP Practitioners (excluding Locums) GP Practitioners (excluding Registrars, Retainers & Locums) : : : : : : : : : 5,231 5,026 : : : : : : : : : 4,991 4,737 GP Providers : : : : : : : : : 3,172 3,243 Other GPs : : : : : : : : : 1,819 1,494 GP Locums 2 : : : : : : : : : 96 216 Registered patients per practitioner (excluding Registrars, Retainers & Locums) 1,610 1,606 1,586 1,520 1,567 1,562 1,569 1,575 1,577 1,607 1,661 1. The headcount methodology is not fully comparable with data for years prior to 2010 due to improvements that make it a more stringent count of absolute staff numbers. Headcount totals are unlikely to equal the sum of components. Further information on the headcount methodology is available in http://content.digital.nhs.uk/pubs/genpermsmar17aa and http://digital.nhs.uk/pubs/genpermsaug17aa (containing some revised figures). 2. GP locums that are reported as actively working at GP practices as of 30 September. This is not the total number of GP locums that are eligible to work in General Practice and are registered on NHS England s National Performers List https://www.performer.england.nhs.uk/ Further information is available in the Data Quality Statement at: http://content.digital.nhs.uk/pubs/genpermsmar17aa 3. Unknown Gender contains estimated practices and those GPs which did not supply gender details. Due to changes in data quality and numbers of estimated staff since September 2015 there are fluctuations in numbers of unknown genders. Therefore, gender comparisons over the time series should be treated with caution. Unknown gender has been taken out of the denominator of the percentage of GPs that are female. r Figures revised following improvements in the reporting systems which have resulted in all GPs recorded with a Not Stated job role in previous publications being retrospectively allocated to their correct role. Copyright 2017, Health and Social Care Information Centre. 10
Table 7: GP trends by gender and GP type, headcount, and registered patients per practitioner in Wales 2006 2007 2008 2009 2010 2011 3 2012 3 2013 2014 2015 2016 GP Headcount GP Practitioners (excluding Locums) 1 GP Practitioners (excluding Registrars, Retainers & Locums) 1 2,095 2,174 2,208 2,156 2,253 2,258 2,257 2,285 2,249 2,253 2,260 1,882 1,936 1,940 1,940 1,991 2,009 1,997 2,026 2,006 1,997 2,009 GP Providers 2,3 1,778 1,778 1,788 1,768 1,776 1,757 1,753 1,740 1,722 1,663 1,606 Other GPs 2,3 104 158 152 172 215 250 243 286 284 334 403 GP Locums 2 : : : : : : : : 609 634 684 GP Headcount Male GP Practitioners (excluding Registrars, Retainers & Locums) 1 1,202 1,204 1,179 1,162 1,162 1,149 1,113 1,082 1,031 991 956 GP Providers 2 : 1,156 1,141 1,112 1,103 1,079 1,062 1,014 966 917 861 Other GPs 2 : 48 38 50 59 78 64 68 65 74 95 GP Headcount Female GP Practitioners (excluding Registrars, Retainers & Locums) 1 680 732 761 778 827 860 884 944 975 1,006 1,053 GP Providers 2 : 622 647 656 672 682 701 726 756 746 745 Other GPs 2 : 110 114 122 155 182 188 218 219 260 308 Percentage of GPs that are female 4 GP Practitioners (excluding Registrars, Retainers & Locums) 1 36.1 37.8 39.2 40.1 41.6 42.8 44.3 46.6 48.6 50.4 52.4 GP Providers 2 : 35.0 36.2 37.1 37.9 38.7 39.8 41.7 43.9 44.9 46.4 Other GPs 2 : 69.6 75.0 70.9 72.4 70.0 74.6 76.2 77.1 77.8 76.4 Registered patients per practitioner (excluding Registrars, Retainers & Locums) 1 1,643 1,598 1,605 1,616 1,584 1,575 1,589 1,569 1,582 1,596 1,592 1. Taken, or derived from the most recent General Medical Practitioners in Wales publication released in March 2017 see Data Sources. 2. Taken, or derived from annual General Medical Practitioners in Wales publications, see Data Sources. 3. Administrative errors were identified relating to the 2011 and 2012 GP Provider and GP Other headcount figures for Wales. Consequently, the figures shown were revised and were first published in General Practice Trend in the UK (to 2013) 4. GPs of unknown gender are not included in the denominator of the percentage of GPs that are female, however they are included in the overall headcounts. Copyright 2017, Health and Social Care Information Centre. 11
Table 8: GP trends by gender and GP type, headcount, and registered patients per practitioner in Scotland 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GP Headcount GP Practitioners (excluding Locums) GP Practitioners (excluding Registrars, Retainers & Locums) 4,598 4,687 4,890 4,906 4,905 4,889 4,865 4,881 4,921 4,938 4,913 4,121 4,198 4,237 4,283 4,253 4,267 4,272 4,258 4,307 4,333 4,326 GP Performer 3,772 3,787 3,785 3,808 3,781 3,753 3,758 3,726 3,719 3,657 3,568 Other GPs 353 416 458 482 479 519 522 542 596 692 773 GP Headcount Male GP Practitioners (excluding Locums) GP Practitioners (excluding Registrars, Retainers & Locums) 2,407 2,399 2,509 2,417 2,384 2,341 2,290 2,231 2,175 2,096 2,017 2,289 2,272 2,262 2,246 2,192 2,169 2,122 2,056 2,012 1,958 1,894 GP Performer 2,158 2,132 2,118 2,108 2,066 2,022 1,980 1,920 1,865 1,779 1,682 Other GPs 134 142 146 143 130 150 147 141 151 185 216 GP Headcount Female GP Practitioner (excluding Locums) GP Practitioners (excluding Registrars, Retainers & Locums) 2,191 2,288 2,381 2,489 2,521 2,548 2,575 2,650 2,746 2,842 2,896 1,832 1,926 1,975 2,037 2,061 2,098 2,150 2,202 2,295 2,375 2,432 GP Performer 1,614 1,655 1,667 1,700 1,715 1,731 1,778 1,806 1,854 1,878 1,886 Other GPs 219 274 312 339 349 369 375 401 445 507 557 Percentage of GPs that are female GP Practitioners (excluding Locums) GP Practitioners (excluding Registrars, Retainers & Locums) 47.7 48.8 48.7 50.7 51.4 52.1 52.9 54.3 55.8 57.6 58.9 44.5 45.9 46.6 47.6 48.5 49.2 50.3 51.7 53.3 54.8 56.2 GP Performer 42.8 43.7 44.0 44.6 45.4 46.1 47.3 48.5 49.9 51.4 52.9 Other GPs 62.0 65.9 68.1 70.3 72.9 71.1 71.8 74.0 74.7 73.3 72.1 Registered patients per practitioner (excluding Registrars, Retainers & Locums) 1,312 1,292 1,292 1,283 1,298 1,295 1,299 1,308 1,300 1,299 1,309 Copyright 2017, Health and Social Care Information Centre. 12
Table 9: GP trends by gender and registered patients per practitioner in Northern Ireland 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GP Headcount GP Headcount (excluding Registrars, Retainers & Locums) 1,110 1,128 1,148 1,156 1,160 1,163 1,170 1,171 1,211 1,274 1,274 GP Headcount Male GP Headcount (excluding Registrars, Retainers & Locums) 703 701 696 687 682 671 657 644 638 635 635 GP Headcount Female GP Headcount (excluding Registrars, Retainers & Locums) 388 427 452 469 478 492 513 527 573 639 639 Percentage of GPs that are female 37.0 37.9 39.4 40.6 41.2 42.3 44.0 45.0 47.0 50.2 50.2 Registered patients per GP Practitioner(excluding Registrars, Retainers & Locums) 1,631 1,625 1,610 1,615 1,623 1,631 1,631 1,639 1,599 1,529 1,539 Copyright 2017, Health and Social Care Information Centre. 13
Table 10: Distribution of GP practices by patient list sizes and by country Patient list size Percentage 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 England 0 to 2,999 22.2 20.8 20.3 20.9 21.2 20.6 18.4 17.1 15.9 13.9 12.3 3,000 to 5,999 31.9 32.1 31.8 31.3 30.6 30.5 30.9 31.0 30.6 30.3 30.1 6,000 to 8,999 22.4 22.8 22.8 22.2 22.3 22.5 23.0 23.3 24.0 24.3 24.6 9,000 to 11,999 14.3 14.6 15.0 15.2 15.1 15.3 15.9 16.4 16.4 17.0 17.2 12,000 to 14,999 6.3 6.6 6.8 7.0 7.2 7.3 7.5 7.8 8.3 8.9 9.4 15,000 + 2.8 3.1 3.3 3.4 3.6 3.9 4.3 4.5 4.9 5.6 6.4 Wales 0 to 2,999 20.4 18.4 18.7 17.4 18.0 17.2 16.3 15.7 13.9 12.4 11.1 3,000 to 5,999 31.1 32.2 31.3 32.2 31.0 30.5 30.2 30.4 30.4 30.5 29.3 6,000 to 8,999 30.3 30.3 30.5 29.5 29.8 29.7 30.7 30.9 32.4 33.3 34.0 9,000 to 11,999 12.2 12.6 13.0 14.0 14.3 15.3 15.0 15.5 15.4 15.5 15.4 12,000 to 14,999 3.6 3.7 3.7 3.9 3.9 3.8 4.2 4.3 4.8 5.1 6.1 15,000 + 2.4 2.9 2.9 2.9 3.1 3.6 3.6 3.2 3.0 3.3 4.1 Scotland 0 to 2,999 29.4 29.5 28.9 28.7 28.1 27.3 26.0 25.6 25.0 24.4 22.7 3,000 to 5,999 33.1 32.7 32.4 32.1 31.9 31.8 33.2 33.2 32.6 32.9 33.2 6,000 to 8,999 23.2 23.0 23.5 23.6 24.0 24.4 23.9 24.1 25.2 25.5 26.8 9,000 to 11,999 11.1 11.4 11.5 11.8 12.2 12.3 12.7 12.7 12.8 12.6 12.1 12,000 to 14,999 2.6 2.7 2.7 2.9 3.0 3.2 3.2 3.4 3.2 3.3 3.5 15,000 + 0.7 0.7 1.0 0.9 0.8 1.0 1.0 1.0 1.1 1.3 1.6 Similar patient list size data are currently unavailable for Northern Ireland. Copyright 2017, Health and Social Care Information Centre. 14
General Practice Staff The following tables present aggregate data to allow greater comparability between UK nations Table 11: General Practice staff trends in England 2006 to 2016 2006 1 2007 1 2008 1 2009 1 2010 2 2011 2 2012 2 2013 2 2014 2 2015 3 2016 3 Practice Staff Headcount Total Practice Staff 1 119,642 117,375 114,483 114,268 136,831 134,177 137,290 138,056 139,352 130,515 132,406 All Nurses 4 : : : : 23,846 23,584 23,458 23,833 23,832 23,066 23,141 All Direct Patient Care 5 Admin/Non- Clinical 6 : : : : 14,297 13,620 15,631 16,339 16,800 14,469 15,326 : : : : 98,688 96,973 98,201 97,884 98,720 93,301 94,295 1. 2007, 2008 and 2009 Practice Staff totals include imputed data based on previous censuses for a number of PCTs who did not submit returns. 2. Prior to 2010 data was collected at a simple aggregated total per PCT. From 2010 the data was collected at practice level. Data was returned for 72.7% of practices in 2010, 89.4% in 2011, 90.2% in 2012, 90.0% in 2013 and 93.0% in 2014. For those practices where data was not supplied an estimate has been made. 3. Prior to 2015 figures were sourced from a manual return provided to NHS Digital by NHS England regions and their predecessors. From 2015 figures are sourced from the wmds and include estimates for missing data. Figures from 2015 onwards are not comparable with previous years. 4. All Nurses are composed of the following categories: Practice Nurse, Advanced Level Nurses, Extended Role and Specialist Nurses, Advanced Nurse Practitioner, Nurse Specialist, Trainee Nurse, District Nurse, Practice Nurse Partner, Extended Role Practice Nurse, Research Nurse, Nurse Dispenser. 5. All Direct Patient Care staff are composed of the following categories: Dispenser, Health Care Assistant, Phlebotomist, Pharmacist, Physiotherapist, Podiatrist, Therapist, Physician Associate, Direct Patient Care Other. 6. Admin/Non-clinical staff are composed of the following categories: Manager, Medical Secretary, Receptionist, Telephonist, Estates and Ancillary, Admin/Estates and Facilities Other. Table 12: General Practice staff trends in Wales 2013 to 2016 2013 2014 2015 2016 Practice Staff Headcount Total Practice Staff 7,270 7,192 7,379 7,341 All Nurses 1 1,296 1,288 1,287 1,327 All Direct Patient Care 2 885 900 909 955 Admin/Non-clinical 3 5,089 5,004 5,183 5,059 1. All Nurses are composed of the following categories: Advanced Nurse Practitioner, Extended Role Nurses, Practice Nurse. 2. All Direct Patient Care are composed of the following categories: anyone who is directly involved in delivering patient care but who is not a nurse or GP. 3. Admin/Non-clinical staff are composed of the following categories: Admin and Clerical and Other (for example Gardeners, Cleaners). Copyright 2017, Health and Social Care Information Centre. 15
Table 13: General Practice staff trends in Scotland 2009 to 2016 2009 2010 2011 2012 2013 2014 2015 Practice Staff Headcount 1 Total Practice Staff : : : : : : : All Nurses 2,140 e : : : 2,125 e : 2,175 e All Direct Patient Care 725 e : : : 870 e : 990 e Admin/Non-clinical : : : : : : : 1. All Nurses are composed of the following categories: Nurse Practitioners, Advanced Nurse Practitioners, General Practice Nurses, Treatment Room Nurses. 2. All Direct Patient Care are composed of the following categories: Health Care Support Workers and Phlebotomists. e= estimated There are currently no comparable General Practice staff figures available for Northern Ireland. Copyright 2017, Health and Social Care Information Centre. 16
Breakdown of Contract Types for England The General and Personal Medical Services, England - 2006-2016, as at 30 September, Provisional Experimental Statistics (published in March 2017) report showed a breakdown of the number of practices and number of GP practitioners (Full Time Equivalent) by contract type. Figures from 2009 are shown in tables 14 and 15. Table 14: Contract type breakdown for GP Practices in England, 2009 to 2016 2009 1 2010 2011 2012 2013 2014 2015 2016 Number of GP Practices 8,228 8,324 8,316 8,088 7,962 7,875 7,674 7527 GP Practices by Contract Type GMS 4,538 4,519 4,553 4,451 4,339 4,421 4,802 5,120 GMS administered by a limited company 16 19 28 7 6 7 6 5 PMS 3,397 3,393 3,316 3,270 3,197 3,143 2,584 2,125 PMS administered by a limited company 23 52 65 20 12 14 13 8 APMS 113 142 141 179 173 191 177 177 APMS administered by a limited company 60 120 135 81 98 99 92 86 PCTMS 2 66 79 78 80 137 : : : Unknown : : : : : : : 6 1. Total number of GP practices contains some unknown contract values due to data not being available for a small number of practices at the time of the 2009 GP census publication. 2. PCTMS contracts ceased to exist following the April 2013 restructure of NHS commissioning organisations in England. Copyright 2017, Health and Social Care Information Centre. 17
Table 15: Contract type breakdown for GP Practitioners (Full Time Equivalent) in England, 2009 to 2016 2009 2010 2011 2012 2013 2014 2015 1,2 2016 1,2 FTE GP Practitioners (excluding Registrars, Retainers & Locums) 3 32,111 31,356 31,391 31,578 32,075 32,628 29,229 r 28,458 FTE Practitioners by contract type 4 GMS 16,289 16,071 16,225 16,285 16,510 17,319 15,875 r 17,109 PMS 14,502 14,346 14,194 14,296 14,396 14,548 9,672 r 7,229 APMS 326 641 689 708 710 761 370 r 342 PCTMS 5 143 188 161 181 404 : : : Source NHS Digital 1. Prior to 2015 contract and FTE figures are sourced from NHAIS GP Payments (Exeter) System. From 2015 figures are sourced from the wmds. Figures from 2015 are not comparable with previous years. 2. Figures contain estimates for practices that did not provide fully valid GP data. Sep 2015 11.9%, Sep 2016 7.6% 3. Totals include counts of GPs whose contract types were unknown and estimated values where data were missing. Therefore, the totals may not equal the sum of the breakdown by contract types. 4. Includes contracts administered by a Limited Company. 5. PCTMS contracts ceased to exist following the April 2013 restructure of NHS commissioning organisations in England. r Figures revised following improvements in the reporting systems which have resulted in all GPs recorded with a Not Stated job role in previous publications being retrospectively allocated to their correct role. Copyright 2017, Health and Social Care Information Centre. 18
Data Sources Population Figures Population Estimates for UK, England and Wales, Scotland and Northern Ireland: Mid- 2016 https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populati onestimates GP Workforce Figures GP workforce information has been grouped according to the current definitions of GPs used by each individual country. NHS Digital General and Personal Medical Services, England http://content.digital.nhs.uk/pubs/genpermsmar17aa http://digital.nhs.uk/pubs/genpermsaug17aa Welsh Government General Medical Practitioners in Wales http://gov.wales/statistics-and-research/general-medical-practitioners/?lang=en Information Services Division Scotland, General Practice http://www.isdscotland.org/health-topics/general-practice/ Northern Ireland Business Services Organisation, General Medical Services www.hscbusiness.hscni.net/services/1804.htm Previous Reports The General Practice Trends in the UK report from earlier years (2010 to 2015) can be found at: http://www.content.digital.nhs.uk/article/2743/technical-steering-committee-tsc- Archive and the archived website of the NHS Information Centre (Pre 2010) at: http://webarchive.nationalarchives.gov.uk/20120802111034/http://ic.nhs.uk/statisticsand-data-collections/supporting-information/primary-care/general-practice/technicalsteering-committee-tsc http://webarchive.nationalarchives.gov.uk/20120802111034/http://www.ic.nhs.uk/statistic s-and-data-collections/supporting-information/primary-care/general-practice/technicalsteering-committee-tsc-archive Copyright 2017, Health and Social Care Information Centre. 19
Definition of GPs England GP Practitioner - a medical practitioner who treats all illnesses and provides preventative care and health education for patients of all ages. GP Provider GP practitioner, who may be a contracted and salaried partner, who has entered into a contract, to provide services to patients. Other GPs GPs that work within partnerships and were formerly known as GMS/PMS others. These practitioners are generally remunerated by salary. GP Locum GP practitioner who provide service sessions in general practice on a temporary and ad hoc basis. This group includes Locums covering vacancy; Locums covering sickness/maternity/paternity and Locums other. Definition of GP Contract Types in England General Medical Services (GMS) is the contract under which most GPs are employed. It is a national agreement between the provider and NHS England which sets out the financial arrangements, the services to be provided and support arrangements. Personal Medical Services (PMS) were first introduced in 1998. They allow the provider to negotiate a local agreement for the services they will provide and payments they will receive, taking into account specific local healthcare needs. Alternative Provider Medical Services (APMS) and Primary Care Trust Medical Services (PCTMS): APMS allow contracts to be bid for by the private, voluntary and public sectors. They offer greater flexibility in the nature of service provision which is decided in agreement between the provider and the commissioner. PCTMS services are provided directly, as well as managed, by NHS England, enabling it therefore to employ health care professionals directly, perhaps as salaried staff, and provide primary medical services itself. PCTMS contracts ceased to exist following the April 2013 restructure of NHS commissioning organisations in England. Wales GP Practitioner - a medical practitioner who treats all illnesses and provides preventative care and health education for patients of all ages. GP Provider is a practitioner who has entered into a contract with a Local Health Board to provide services to patients. Copyright 2017, Health and Social Care Information Centre. 20
Other GPs GPs that work within partnerships and were formerly known as GMS Others. These practitioners are generally remunerated by salary. GP Locum GPs who deputises temporarily at a GP Practice, usually to cover for an absent GP Practitioner. Such cover should last for no more than 6 months. Scotland GP Practitioner - a medical practitioner who treats all illnesses and provides preventative care and health education for patients of all ages. Performer GP performers that are not salaried, i.e. generally the practice partners. Other GPs performer salaried GPs who are employed by the practice or NHS Board on a salaried basis. Northern Ireland GP Practitioner - a medical practitioner who treats all illnesses and provides preventative care and health education for patients of all ages. Number of GPs GPs that are practice partners and salaried GP. For further information on historical reclassification and changes to definitions of GPs, please see previous versions of the GP Practice Trends report. Copyright 2017, Health and Social Care Information Centre. 21
General Practice Trends in the UK to 2016 www.digital.nhs.uk 0300 303 5678 enquiries@nhsdigital.nhs.uk @nhsdigital This publication may be requested in large print or other formats. Published by NHS Digital, part of the Government Statistical Service Copyright 2017 Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. You may re-use this document/publication (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence v3.0. To view this licence visit www.nationalarchives.gov.uk/doc/open-government-licence or write to the Information Policy Team, The National Archives, Kew, Richmond, Surrey, TW9 4DU; or email: psi@nationalarchives.gsi.gov.uk Copyright 2017, Health and Social Care Information Centre. 22