News, Primary Care News

New interactive dashboard shows local GP inequalities across England

The Primary Care Unit at the University of Cambridge has created a new, interactive dashboard which allows local health systems to view the inequalities in the distribution of the general practice workforce, across individual practices and areas.

Hosted on the Primary Care Unit website, the dashboard shows data from across all areas of England, which can be filtered by staff role, such as GPs, nurses, and total direct patient care (DPC) staff, as well as the quarter – from March to December 2020 – or by the Sustainability and Transformation Plan (STP) area.

This information allows planners, managers and policy makers within healthcare to see, for example, how many full-time equivalent (FTE) GPs or nurses there are per 10,000 patients in any given practice. As well as showing national inequalities in staffing coverage and GP supply, this data can also help local healthcare providers and decision makers to drill down into the detail of which practices have the least total DPC staff supporting their local populations.

Next to this information, users of the dashboard can also view individual practice’s socio-economic gradient via average Indices of Multiple Deprivation score and IMD Quintile – datasets that act as markers of deprivation level in small areas, and which – when placed next to the staffing data – illustrate how much support the most and least deprived areas within individual STPs have relative to their level of deprivation.

The quintiles are 1 to 5 – with 1 the signifying the lowest deprivation and 5 the highest deprivation.

Overall, the map of England is also colour-coded by STP, to illustrate the average number of FTE GPs, nurses or total DPC staff per 10,000 patients across the country – to provide a wider, national-level overview of the staffing and support situation in different areas.

Titled ‘Inequalities in the distribution of the general practice workforce’, the dashboard introduction states that “fair distribution of primary care staff is a key building block to reducing health and care inequalities” and that it obtained its workforce data from the NHS Digital General Practice Workforce collection and its Index of Multiple Deprivation (IMD) data from the Fingertips National General Practice Profiles.

It does also note that the data displayed is “not adjusted for age, sex, or other characteristics related to patient need” and only reflects “the raw number of FTE staff per 10,000 patients in each practice”.

As well as mapping inequalities within local workforces, the team behind the dashboard also recently had a paper published on BJGP Open, which explores further inequalities within the primary care workforce.

The longitudinal study used quarterly General Practice Workforce datasets across England, between 2015 to 2020, with the “slope indices of inequality (SIIs) for GPs, nurses, total direct patient care (DPC) staff, PAs, pharmacists, and paramedics per 10 000 patients” calculated quarterly and “plotted over time, with and without adjustment for patient need.”

In summary, the authors found that “fewer GPs, total DPC staff, and paramedics per 10 000 patients were employed in more deprived areas” but that “more PAs and pharmacists per 10 000 patients were employed in more deprived areas” and “unadjusted analysis” also “showed more nurses per 10 000 patients employed in more deprived areas”.

“With the exception of total DPC staff, these observed inequalities widened over time,” the paper noted.

In conclusion, the paper’s authors stated: “Significant workforce inequalities exist and are even increasing for several key general practice roles, with workforce shortages disproportionately affecting more deprived areas. Policy solutions are urgently needed to ensure an equitably distributed workforce and reduce health inequities.”

To read the full report, click this DOI link to view the paper, which was written by Claire NussbaumEfthalia MassouRebecca FisherMarcello MorcianoRachel Harmer and John Ford, and which is available to share via Open Access: CC BY license