Flawed data on GP consultations could put unfair pressure on practices, warns GPC

GPs could face unfair pressure to increase the number of appointments they offer because of variations in how practices record data, the GPC has warned.

NHS Digital is due to begin collecting practice-level data from GP IT systems by 10 September to assess factors including numbers of appointments offered and scheduled, types and times of appointments and the type of health professional offering the appointment.

The data collection - part of a drive to gather more accurate information on GP workload - will also look at DNAs, cancellations, numbers of patients who use large numbers of appoinments and overall availability of appointments through the 'third next available appointment' measure.

IT systems suppliers will set up practice computers to allow the collection of historic data from as far back as 2015 to allow comparisons with more recent workload measures.

GP appointments

Meanwhile, NHS Digital confirmed this month that it will also collect data weekly on future appointment availability to 'improve understanding of appointments capacity and utilisation in general practice and inform more effective planning and management of capacity at local and regional levels'.

NHS England hopes the data will help with planning for winter pressures across the health service. NHS Digital board papers say 'it will aid the understanding of seasonal pressures at national level to inform the wider strategy on the provision of services across primary and secondary care, and allow tracking of improvements in patient access to general practice'.

But GPC chair Dr Richard Vautrey told GPonline that variations in how practices record information about appointments risked making the data largely meaningless, and could open practices up to unfair criticism based on inaccurate assumptions.

Dr Vautrey said that 'the way practices open consultations, close them, use or record types of consultation' could be significantly different.

'Do they record home visits, or telephone consultations in the same way?' he said. 'There are real difficulties in standardising that information.

Telephone consultations

'It is really difficult to compare a series of telephone consultaions with a series of consultations that are complex and face-to-face. And how do you compare it with a home visit? There may be a quick input when you return to the practice, but the consultation itself may have lasted an hour.'

Converting data from different practices, recording data in different ways meant there was a risk that when the information was converted into simple numbers 'it doesn't mean anything'. Data could also be affected by changes in appointments systems to reflect gaps in the practice workforce due to annual leave or vacancies, and some practices may simply create appointments when patients call rather than listing them as available beforehand, he suggested.

Data may also be affected by how practices handle patients presenting with multiple issues - some may record a double appointment, while others handle more than one issue in a single, longer appointment.

'The risk is those who don’t understand the information misuse it, and it becomes a further stick to beat practices with,' warned Dr Vautrey. Practices could be unfairly compared with their neighbours and asked why they offer fewer appointments, for example.

'The risk is you suck out data and try to make sense of it and you can't - it may raise more questions than answers. There is a need for better quality data but need to understand the limitations of the data.'

NHS Digital's board papers suggest that part of the aim of the process is to 'inform standardisation of the collection of appointment data', and acknowledges that variable data quality may 'impact on utilisation'. NHS England will carry out the majority of analysis and further use of the data, the board paper says, and publication of the data by NHS Digital would 'clearly highlight any caveats and data quality issues'.

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