Lara Shemtob is an Academic Clinical Fellow in General Practice at Imperial College London
The Appointments in General Practice data available° on the NHS Digital website collects data on the activity recorded within appointment systems for much of general practice across England.
The April 2020 data° contain a disclaimer about the impact of COVID-19 on data quality, acknowledging the change in work patterns that may not be easily traceable given “there are no national standards for data entry into GP systems which are not primarily designed for data analysis purposes”. NHS Digital recommends we treat the April 2020 data as experimental statistics given these limitations. To what extent has the data captured the degree to which general practice has changed over the last few months, and what can be done to improve the data quality?
Without recording and measuring activity properly, it is impossible to track change and progress.
While the national data (Table 1) has captured some of the trends we have seen on the ground: reduced appointment activity, with more patients being offered same day appointments, more of these being telephone vs fewer face to face appointments, the data on the percentage of video consultations that took place do not reflect the impressive degree of rapid change we have seen over the last few months.
|April 2019°||April 2020°|
|Open active practices||6,974||6,775|
|Total count of appointments||22,829,868||15,835,467|
|Appointment status (Percentage of total)||Attended 89.8%
Did not attend 4.9%
Did not attend 3.0%
|Healthcare professional involved (Percentage of total)||GP 53.0%
Other practice staff 44.3%
Other practice Staff 42.0%
|Percentage of total offered same day appointment||42.9||63.3|
|Appointment mode (Percentage of total)||Face-to-face 82.6%
Home visit 1.0%
Home visit 0.6%
We have been troubleshooting challenges with data entry at the practice level through the pandemic, setting up new ways to document different types of consultation to help audit the outcomes and effectiveness of these new ways of working.
We cannot rely on the experimental data that has been collected over the last two months.
The national report from April shows holes in our local data entry, and likely in the collection methods too. There needs to be more clarity on how these national data are gathered, and how to optimise our local data entry for this as well as for use at the practice/PCN level. We cannot rely on the experimental data that has been collected over the last two months, but now that we are catching up with the rapid changes in working since March and with talk of the new ways of working becoming permanent, when will the data quality catch up? Without recording and measuring activity properly, it is impossible to track change and progress.