General practice data dashboard Monitoring data on general practice

Introduction

General practice in England is under significant pressure. Patient demand is rising, but the number of full-time equivalent GPs has fallen. Addressing declining public satisfaction and concerns about access are high on the agenda for patients and policymakers. This dashboard brings together a range of data to provide a picture of the current health of primary care in England. We have chosen a set of indicators that highlight key issues in general practice across eight domains – access, activity, continuity of care, coordination, patient and public experiences, financing, workforce, quality and outcomes.

This dashboard isn’t intended to rate the overall performance of general practice but rather provide a broad picture of the state of general practice in the NHS, and how it is changing. The dashboard will be regularly updated over time. 

Unless otherwise stated, data in this dashboard cover England only.

Access

Access relates to how patients contact and receive care from their general practice. Access is complex, beginning well before a patient contacts their practice and ending long after an appointment. A full understanding of access would require more data than currently available, but here we present three important aspects – patient experience contacting their practice, the types of professionals patients see and the modes of consultation.  

Activity

Activity refers to what is happening in general practice and how frequently it takes place. We present data on the number of appointments and referrals, which are useful high-level measures of key general practice activity. However, these measures still need to be interpreted with caution, as they don’t cover the full range of work happening in general practice. Such work includes clinical supervision, teaching and training, administrative work, quality improvement projects, liaising with other parts of the system, patient advocacy and running the practice business. Compared with secondary care, there is relatively limited activity data for general practice in the NHS.

Continuity of care

Continuity of care includes the quality of a patient's relationship with their care provider over time, whether the right information about the patient is available to the provider they see and whether care is managed consistently by different caregivers. Continuity is a central pillar of general practice care and is associated with a range of benefits, including higher productivity, lower avoidable hospital admissions and higher patient and staff satisfaction. Measuring continuity is complex, but a patient’s ability to see their preferred GP over time remains an important measure.

Coordination

Coordination relates to how different elements of care are brought together around the patient. General practice plays a key role in coordinating care, regularly liaising with hospitals, social care, community services and community organisations. Up-to-date, systematic information on the quality of coordination between different services is lacking. However, the perceptions of GPs and patients on coordination between primary and secondary care can offer valuable insights.

Patient and public experience 

Patient and public experience refers to how patients feel about the care they receive and what the public thinks about general practice services overall. A range of survey data is available about people’s experiences of general practice, including the annual GP Patient Survey and the Health Foundation’s own polling. These data can help us understand whether general practice is meeting the expectations and needs of patients and the public.

Funding

Funding covers how much money general practice receives, how this money is distributed and how the amount compares with other parts of the NHS. Here, we show government investment in general practice over time, adjusted for inflation. Most of this investment is made through NHS national and local commissioning, so we show what percentage of the total NHS commissioning spend in England goes towards general practice compared with other sectors, such as hospitals. We also show how the amount of funding each practice receives through its core GP contract varies according to how socioeconomically deprived the area it serves is.  

Workforce

Workforce relates to the number, type and distribution of staff working in general practice and primary care networks. The types of jobs GPs take in general practice – whether they are partners in a practice, salaried practice employees, or fill in for absent GPs as locums –has implications for patient care (for example, regarding continuity of care) as well as practice management. While GPs and nurses remain at the centre of the general practice team, a range of other patient care staff now work alongside them, and we show how the general practice workforce is changing over time. We also look at how the distribution of staff compares with population health needs.

Quality and outcomes

Quality of care and outcomes refers to the impact on patient health from receiving general practice care and how good general practice is at delivering that care. Attributing outcomes to general practice is challenging given that GPs often manage patients with complex care needs over long periods and there are range of influences on health outside the control of general practice. Understanding the relationship between quality of care in general practice and patient outcomes is therefore complex. Clinical outcomes measured through the Quality and Outcomes Framework (QOF), inspection ratings from regulators and GPs’ perceptions of the quality of their care are limited but still useful ways of exploring these topics.

Contact us  

If you have any questions or comments about the dashboard, please contact Jake Beech, Policy Fellow.